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Revista Espanola de Enfermedades... Nov 2018Meckel's diverticulum is the most common anomalous development of the gastrointestinal system that results from an incomplete vitelline canal. A diagnosis is usually... (Review)
Review
Meckel's diverticulum is the most common anomalous development of the gastrointestinal system that results from an incomplete vitelline canal. A diagnosis is usually made during the clinical examination of presentations such as unexplained gastrointestinal bleeding, obstruction, inflammation or perforation. The purpose of this review is to provide an adequate level of knowledge of the clinical and diagnostic features as well as the management of Meckel's diverticulum. Diagnosis of Meckel's diverticulum may be challenging as the condition remains asymptomatic or may mimic various diseases and obscure the clinical picture. Life-threatening complications include bleeding, obstruction, inflammation and perforation. Therefore, it is essential that anatomical and pathophysiological characteristics are known in detail in order to prevent complications which will result in morbidity and mortality.
Topics: Humans; Meckel Diverticulum
PubMed: 30032625
DOI: 10.17235/reed.2018.5628/2018 -
Medicine Aug 2018The contemporary demographics and prevalence of Meckel's diverticulum, clinical presentation and management is not well described. Thus, this article aims to review the... (Review)
Review
BACKGROUND
The contemporary demographics and prevalence of Meckel's diverticulum, clinical presentation and management is not well described. Thus, this article aims to review the recent literature concerning Meckel's diverticulum.
METHODS
A systematic PubMed/Medline database search using the terms "Meckel" and "Meckel's" combined with "diverticulum." English language articles published from January 1, 2000 to July 31, 2017 were considered. Studies reporting on the epidemiology of Meckel's diverticulum were included.
RESULTS
Of 857 articles meeting the initial search criteria, 92 articles were selected. Only 4 studies were prospective. The prevalence is reported between 0.3% and 2.9% in the general population. Meckels' diverticulum is located 7 to 200 cm proximal to the ileocecal valve (mean 52.4 cm), it is 0.4 to 11.0 cm long (mean 3.05 cm), 0.3 to 7.0 cm in diameter (mean 1.58 cm), and presents with symptoms in 4% to 9% of patients. The male-to-female (M:F 1.5-4:1) gender distribution is reported up to 4 times more frequent in men. Symptomatic patients are usually young. Of the pediatric symptomatic patients, 46.7% have obstruction, 25.3% have hemorrhage, and 19.5% have inflammation as presenting symptom. Corresponding values for adults are 35.6%, 27.3%, and 29.4%. Ectopic gastric tissue is present in 24.2% to 71.0% of symptomatic Meckel's diverticulum, is associated with hemorrhage and is the most common form of ectopic tissue, followed by ectopic pancreatic tissue present in 0% to 12.0%.
CONCLUSION
The epidemiological patterns and clinical presentation appears stable in the 21st century. A symptomatic Meckel's diverticulum is managed by resection. The issue of prophylactic in incidental Meckel's diverticulum resection remains controversial.
Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Choristoma; Disease Management; Female; Humans; Ileocecal Valve; Male; Meckel Diverticulum; Middle Aged; Pancreas; Prevalence; Sex Distribution; Stomach; Young Adult
PubMed: 30170459
DOI: 10.1097/MD.0000000000012154 -
Annals of Surgery Feb 2011Surgical management of incidental Meckel's diverticulum(MD) is a highly debated controversial issue that has never been discussed from the oncological standpoint.
BACKGROUND
Surgical management of incidental Meckel's diverticulum(MD) is a highly debated controversial issue that has never been discussed from the oncological standpoint.
OBJECTIVE
To describe the epidemiology and risk of Meckel's diverticulum cancer (MDC) and compare it with other ileal malignancies.
METHODS
Data were obtained from 163 cases of MDC and 6214 cases of non-Meckelian ileal cancer, between 1973 and 2006, from the Surveillance, Epidemiology, and End Results database.
RESULTS
Mean annual incidence was 1.44 (± 1.12) per 10 million population,with a 5-fold increase in the last few decades. Incidence increases with age,with a mean age at diagnosis of 60.6 (±15.1) years. Adjusted risk of cancer in the MD was at least 70 times higher than any other ileal site. Disease was localized in 67% at presentation and malignant carcinoids constituted the major histologic type (77%). One-third of patients have had lifetime occurrence of other malignancies and in 13% of these patients, MDC was the first malignancy. Median tumor size was 7 mm. Median overall survival was 173 months (95% confidence interval [CI], 124-221 months), with 1- and 5-year relative survival rates of 85.8% (95% CI, 76.9%-91.4%) and 75.8% (95%CI, 64.9%-83.8%), respectively. Cox proportional hazards model revealed that age, histologic type, and metastatic disease were independent factors affecting survival.
CONCLUSIONS
MD is a "hot-spot" or high-risk area for cancer in the ileum.With risk that increases with age and high possibility of curative resection with negligible operative mortality, incidental MD is best treated with resection.
Topics: Adenocarcinoma; Age Distribution; Aged; Carcinoid Tumor; Female; Humans; Ileal Neoplasms; Incidence; Male; Meckel Diverticulum; Middle Aged; Prevalence; SEER Program; Sex Distribution; United States
PubMed: 21135700
DOI: 10.1097/SLA.0b013e3181ef488d -
Saudi Journal of Gastroenterology :... 2010Meckel's diverticulum is a true intestinal diverticulum that results from the failure of the vitelline duct to obliterate during the fifth week of fetal development. In... (Review)
Review
Meckel's diverticulum is a true intestinal diverticulum that results from the failure of the vitelline duct to obliterate during the fifth week of fetal development. In about 50% cases, it contains ectopic or heterotopic tissue which can be the cause of complications. A systematic review of literature was undertaken to study the history, incidence, embryoanatomy, clinical presentation, complication and management of Meckel's diverticulum. Although Meckel's diverticulum is the most common congenital abnormality of the gastrointestinal tract, it is often difficult to diagnose. It may remain asymptomatic or it may mimic disorders such as Crohn's disease, appendicitis and peptic ulcer disease.
Topics: Diagnosis, Differential; Humans; Meckel Diverticulum
PubMed: 20065566
DOI: 10.4103/1319-3767.58760 -
Journal of Nuclear Medicine Technology Sep 2020: For CE credit, you can access the test for this article, as well as additional JNMT CE tests, online at https://www.snmmilearningcenter.org Complete the test online no... (Review)
Review
: For CE credit, you can access the test for this article, as well as additional JNMT CE tests, online at https://www.snmmilearningcenter.org Complete the test online no later than September 2023. Your online test will be scored immediately. You may make 3 attempts to pass the test and must answer 80% of the questions correctly to receive 1.0 CEH (Continuing Education Hour) credit. SNMMI members will have their CEH credit added to their VOICE transcript automatically; nonmembers will be able to print out a CE certificate upon successfully completing the test. The online test is free to SNMMI members; nonmembers must pay $15.00 by credit card when logging onto the website to take the test.
Topics: Artifacts; Humans; Image Interpretation, Computer-Assisted; Meckel Diverticulum; Molecular Imaging; Patient Education as Topic
PubMed: 32883776
DOI: 10.2967/jnmt.120.251918 -
Journal of Nuclear Medicine Technology Sep 2020
Topics: Diagnostic Imaging; Humans; Image Processing, Computer-Assisted; Meckel Diverticulum
PubMed: 32883774
DOI: 10.2967/jnmt.120.244137 -
Journal of Visceral Surgery Sep 2017Meckel's diverticulum (MD) is the most common gastro-intestinal congenital malformation (approximately 2% in the overall population). The lifetime risk of related... (Review)
Review
Meckel's diverticulum (MD) is the most common gastro-intestinal congenital malformation (approximately 2% in the overall population). The lifetime risk of related complications is estimated at 4%. These include gastro-intestinal bleeding, obstruction or diverticular inflammation. Diagnosis is difficult and rarely made, and imaging, especially in the case of complicated disease, is often not helpful; however exploratory laparoscopy is an important diagnostic tool. The probability of onset of complication decreases with age, and the diagnosis of MD in the adult is therefore often incidental. Resection is indicated in case of complications but remains debatable when MD is found incidentally. According to an analysis of large series in the literature, surgery is not indicated in the absence of risk factors for complications: these include male gender, age younger than 40, diverticulum longer than two centimetres and the presence of macroscopically mucosal alteration noted at surgery. Resection followed by anastomosis seems preferable to wedge resection or tangential mechanical stapling because of the risk of leaving behind abnormal heterotopic mucosa.
Topics: Adult; Humans; Laparoscopy; Meckel Diverticulum
PubMed: 28698005
DOI: 10.1016/j.jviscsurg.2017.06.006 -
The British Journal of Radiology May 2014The Meckel's diverticulum is the commonest congenital anomaly of the gastrointestinal tract, often presenting with complications such as gastrointestinal bleeding,... (Review)
Review
The Meckel's diverticulum is the commonest congenital anomaly of the gastrointestinal tract, often presenting with complications such as gastrointestinal bleeding, intussusception, bowel obstruction and diverticulitis, which are often misdiagnosed. Imaging plays an important role in the early diagnosis and characterization of these conditions and is very helpful in decision making. The Meckel's diverticulum and its complications have myriad presentations and appearances on various imaging modalities. Thus, sound knowledge of the anatomy, embryology, clinical presentation, imaging characteristics and complications is crucial to the practice of abdominal imaging. We present a review of the literature and current radiological practices in the diagnosis and management of the Meckel's diverticulum and its various complications with special emphasis on the imaging of various complications, mimickers and pathological correlation.
Topics: Diagnosis, Differential; Diagnostic Imaging; Humans; Intestinal Diseases; Meckel Diverticulum
PubMed: 24611767
DOI: 10.1259/bjr.20130743 -
BMJ Case Reports Mar 2021Meckel's diverticulum is the most common intestinal congenital defect, its prevalence is 0.2%-4.0% and it occurs more commonly in children younger than 2-year old with...
Meckel's diverticulum is the most common intestinal congenital defect, its prevalence is 0.2%-4.0% and it occurs more commonly in children younger than 2-year old with intestinal bleeding and abdominal pain. Perforation in the elderly is very rare with no more than 35 articles reported worldwide. Here we report the case of a 62-year-old man who was admitted to hospital with a history of acute abdominal pain with a 20-day onset. The patient was treated with laparotomy and 30 cm ileal resection was performed for an 8×5 cm perforated ileum tumour at 50 from ileocecal valve with a side-to-side mechanical anastomosis for reconstruction. Having morbidity Clavien-Dindo scale I in postsurgical and good outcome in 6-month follow-up. Meckel's diverticulum is an infrequent pathology in paediatric and even rarer in adult population, however, it is always important to keep in mind how to act when is seen either as a finding or as a complication.
Topics: Abdominal Pain; Adult; Aged; Child; Child, Preschool; Gastrointestinal Hemorrhage; Humans; Ileocecal Valve; Laparotomy; Male; Meckel Diverticulum; Middle Aged
PubMed: 33782062
DOI: 10.1136/bcr-2020-237840