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Pediatric Emergency Care Oct 2021Children with abdominal pain are frequently seen in emergency departments. Physicians and parents worry about appendicitis; physicians are also concerned about...
Children with abdominal pain are frequently seen in emergency departments. Physicians and parents worry about appendicitis; physicians are also concerned about intussusception and bowel obstruction in patients with previous surgical procedures. Sometimes the patient is ill, and the diagnosis is elusive. In a 6-month period at our pediatric emergency department with an annual census of 57,400 patients, we cared for 4 patients who presented with abdominal pain due to complications of Meckel's diverticulum. None presented with painless rectal bleeding, the complication of which physicians are most aware. We are reporting these patients to raise awareness of Meckel's diverticulum as a cause of acute abdomen in children. Meckel's diverticulum may masquerade as appendicitis, an abdominal mass, intussusception, or a complication of severe constipation.
Topics: Abdomen, Acute; Abdominal Pain; Child; Humans; Intestinal Obstruction; Intussusception; Meckel Diverticulum
PubMed: 34507344
DOI: 10.1097/PEC.0000000000002537 -
Southern Medical Journal Jun 1993Meckel's diverticula are the result of incomplete degeneration of the vitelline duct. It is generally believed that less than 5% of them become symptomatic, the... (Review)
Review
Meckel's diverticula are the result of incomplete degeneration of the vitelline duct. It is generally believed that less than 5% of them become symptomatic, the frequency decreasing with age. Meckel's diverticula are most commonly manifested in children by painless lower gastrointestinal bleeding and in adults, as an inflammatory process or obstruction. Definitive diagnosis is usually made at surgery, though the Meckel's scan may suggest a diagnosis preoperatively, especially in the pediatric population. All symptomatic and pathologic Meckel's diverticula should be removed with a segment of ileum. The use of stapling devices, with their ease of use and low complication rate, make it reasonable to remove any Meckel's diverticulum that easily fits in the device. If a diverticulum found incidentally is so broad-based or short that stapling cannot be done without difficulty, it is unlikely to become symptomatic and should be left undisturbed.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Female; Humans; Male; Meckel Diverticulum; Middle Aged; Treatment Outcome
PubMed: 8506491
DOI: 10.1097/00007611-199306000-00017 -
Southern Medical Journal Nov 2004
Topics: Adult; Diverticulitis; Female; Humans; Male; Meckel Diverticulum
PubMed: 15586588
DOI: 10.1097/01.smj.0000125173.24615.d4 -
South African Journal of Surgery.... Aug 2000Meckel's diverticulum is the most common congenital abnormality of the small intestine. A case of Meckel's diverticulum duplication is described, believed to be the... (Review)
Review
Meckel's diverticulum is the most common congenital abnormality of the small intestine. A case of Meckel's diverticulum duplication is described, believed to be the first report of this kind in the literature.
Topics: Adolescent; Humans; Intestinal Obstruction; Male; Meckel Diverticulum
PubMed: 11392199
DOI: No ID Found -
Journal of Gastroenterology and... Apr 2021
Topics: Abdominal Pain; Aged; Capsule Endoscopes; Capsule Endoscopy; Female; Foreign Bodies; Humans; Meckel Diverticulum; Recurrence; Time Factors; Tomography, X-Ray Computed
PubMed: 33190336
DOI: 10.1111/jgh.15300 -
ANZ Journal of Surgery Jul 2021
Topics: Foreign Bodies; Humans; Ilium; Intestinal Perforation; Meckel Diverticulum; Pain
PubMed: 33300262
DOI: 10.1111/ans.16486 -
Annals of Surgery Mar 2005Through a comprehensive review of the Mayo Clinic experience with patients who had Meckel diverticulum, we sought to determine which diverticula should be removed when...
OBJECTIVE
Through a comprehensive review of the Mayo Clinic experience with patients who had Meckel diverticulum, we sought to determine which diverticula should be removed when discovered incidentally during abdominal surgery.
SUMMARY BACKGROUND DATA
Meckel diverticula occur so infrequently that most articles have reported either small series or isolated cases. From these limited series, various conclusions have been reported without clearly indicating which incidental diverticula should be removed.
METHODS
Medical records were reviewed of 1476 patients found to have a Meckel diverticulum during surgery from 1950 to 2002. Preoperative diagnosis; age; sex; date of surgery; and intraoperative, macroscopic, and microscopic findings from operative and pathology reports were recorded. Logistic regression analysis was used to determine which clinical or histologic features were associated with symptomatic Meckel diverticulum. The features analyzed were age; sex; length, base width, and ratio of length to base width of the diverticulum; and the presence of ectopic tissue or abnormal tissue (inflammation or enteroliths).
RESULTS
Among the 1476 patients, 16% of the Meckel diverticula were symptomatic. The most common clinical presentation in adults was bleeding; in children, obstruction. Among patients with a symptomatic Meckel diverticulum, the male-female ratio was approximately 3:1. Clinical or histologic features most commonly associated with symptomatic Meckel diverticula were patient age younger than 50 years (odds ratio [OR], 3.5; 95% confidence interval [CI], 2.6-4.8; P < 0.001), male sex (OR, 1.8; 95% CI, 1.3-2.4; P < 0.001); diverticulum length greater than 2 cm (OR, 2.2; 95% CI, 1.1-4.4; P = 0.02), and the presence of histologically abnormal tissue (OR, 13.9; 95% CI, 9.9-19.6; P < 0.001).
CONCLUSIONS
After analyzing our data, we neither support nor reject the recommendation that all Meckel diverticula found incidentally should be removed, although the procedure today has little risk. If a selective approach is taken, we recommend removing all incidental Meckel diverticula that have any of the 4 features most commonly associated with symptomatic Meckel diverticulum.
Topics: Adult; Child; Female; Humans; Incidental Findings; Male; Meckel Diverticulum; Postoperative Complications
PubMed: 15729078
DOI: 10.1097/01.sla.0000154270.14308.5f -
ANZ Journal of Surgery Oct 2022
Topics: Hernia; Humans; Intestinal Obstruction; Meckel Diverticulum
PubMed: 35852965
DOI: 10.1111/ans.17920 -
European Journal of Pediatrics Dec 2009A technetium-99m pertechnetate Meckel scan is the standard diagnostic test to diagnose Meckel diverticulum. Although a negative scan does not exclude Meckel...
A technetium-99m pertechnetate Meckel scan is the standard diagnostic test to diagnose Meckel diverticulum. Although a negative scan does not exclude Meckel diverticulum, it should be kept in mind that the diagnosis can be missed on the basis of a single negative scan. Another important point is the typical position of this anatomical abnormality in the scan. We report a peculiar anatomical variation of Meckel diverticulum as seen in the technetium-99m pertechnetate scan. Recognizing this variant of Meckel diverticulum is important to avoid missing such a potentially life-threatening congenital anomaly.
Topics: Choristoma; Female; Gastric Mucosa; Humans; Infant; Meckel Diverticulum; Radionuclide Imaging; Radiopharmaceuticals; Sodium Pertechnetate Tc 99m
PubMed: 19242720
DOI: 10.1007/s00431-009-0946-8 -
Journal de Radiologie Mar 2004Meckel's diverticulum is a persistent embryonic remnant occurring in 2% of the general population. As an "ileal appendix", it is usually clinically silent and only... (Review)
Review
Meckel's diverticulum is a persistent embryonic remnant occurring in 2% of the general population. As an "ileal appendix", it is usually clinically silent and only discovered at the time of complications: inflammation, hemorrhage, obstruction, tumor. The preoperative diagnosis is rarely made because of the non specific nature of the symptomatology and only about 10% of complicated cases are diagnosed at imaging. Complications from Meckel's diverticulum should always be considered in patients presenting with an acute abdomen, especially in young adults.
Topics: Humans; Meckel Diverticulum; Radiography
PubMed: 15192518
DOI: 10.1016/s0221-0363(04)97578-6