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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 -
The American Journal of Gastroenterology Jul 1990
Review
Topics: Diagnosis, Differential; Humans; Intestinal Neoplasms; Intestinal Obstruction; Meckel Diverticulum; Melena
PubMed: 2196781
DOI: No ID Found -
American Family Physician Feb 2000Although Meckel's diverticulum is the most prevalent congenital abnormality of the gastrointestinal tract, it is often difficult to diagnose. It may remain completely... (Review)
Review
Although Meckel's diverticulum is the most prevalent congenital abnormality of the gastrointestinal tract, it is often difficult to diagnose. It may remain completely asymptomatic, or it may mimic such disorders as Crohn's disease, appendicitis and peptic ulcer disease. Ectopic tissue, found in approximately 50 percent of cases, consists of gastric tissue in 60 to 85 percent of cases and pancreatic tissue in 5 to 16 percent. The diagnosis of Meckel's diverticulum should be considered in patients with unexplained abdominal pain, nausea and vomiting, or intestinal bleeding. Major complications include bleeding, obstruction, intussusception, diverticulitis and perforation. The most useful method of diagnosis is with a technetium-99m pertechnetate scan, which is dependent on uptake of the isotope in heterotopic tissue. Management is by surgical resection.
Topics: Female; Humans; Meckel Diverticulum; Middle Aged; Patient Education as Topic; Teaching Materials
PubMed: 10706156
DOI: No ID Found -
Annals of Surgery Jan 1976One hundred and ninety surgically documented cases of Meckel's diverticulum encountered at the Mayo Clinic during a 51-year period, 1920 through 1971, are reviewed. In...
One hundred and ninety surgically documented cases of Meckel's diverticulum encountered at the Mayo Clinic during a 51-year period, 1920 through 1971, are reviewed. In 39 patients, the diverticulum was left undisturbed. In 51 patients, the diverticulum was the primary surgical disease, and, in 100 patients, the diverticulum was removed incidentally. The clinical features are presented as well as the surgical considerations. Meckel's diverticulum is a relatively frequent development anomaly with eccentric manifestations, and its surgical management has intrigued physicians for over 350 years. Dr. Charles W. Mayo stated, "Meckel's diverticulum is frequently suspected, often looked for, and seldom found."
Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Male; Meckel Diverticulum; Middle Aged; Postoperative Complications
PubMed: 1247297
DOI: 10.1097/00000658-197601000-00006 -
International Journal of Emergency... Aug 2010Perforation of a Meckel diverticulum (MD) is a rare complication that can often mimic appendicitis. This case report identifies a child who presented to our Emergency...
Perforation of a Meckel diverticulum (MD) is a rare complication that can often mimic appendicitis. This case report identifies a child who presented to our Emergency Department (ED) with right lower quadrant abdominal pain, free fluid and air in the abdomen and pelvis, and inflammatory changes visualized on Ultrasonography (US) and computer tomography (CT) scan. In our patient, ruptured appendicitis was suspected, and the diagnosis of ruptured MD was ultimately made by laparoscopy. This case demonstrates that a healthy degree of suspicion for complicated MD should be present when dealing with a questionable diagnosis of appendicitis, particularly in the pediatric population.
PubMed: 21373322
DOI: 10.1007/s12245-010-0213-9 -
Acta Medica Academica Dec 2022The objective of the current study was to describe the anatomical variations of vessels observed in patients with Meckel's Diverticulum. (Review)
Review
OBJECTIVE
The objective of the current study was to describe the anatomical variations of vessels observed in patients with Meckel's Diverticulum.
METHODS
A narrative review of the literature was undertaken by means of the PubMed database, using the terms: "Meckel's Diverticulum AND vessels", "Meckel's Diverticulum AND anatomical variation" and "Meckel's Diverticulum variation". Classical anatomical textbooks were also used for normal anatomy. Additional articles provided useful information in relation to the aim of this review. Hence, the articles that met the inclusion criteria were included in this review, and the collected data were categorized into a single table.
RESULTS
The majority of studies indicated the presence of an abnormal vitelline artery. Other angiographic findings concerned variations of the ileal and the iliac arteries. However, the literature revealed the presence of vascular variations without the existence of Meckel's Diverticulum, whereas a remnant of the vitelline vein may be present, but it is very rare.
CONCLUSION
The detection of vascular variations accompanying Meckel's Diverticulum is not always easy and requires the correct choice of imaging method to prevent misdiagnosis.
Topics: Humans; Meckel Diverticulum; Ileum; Angiography; Arteries; Veins
PubMed: 36799317
DOI: 10.5644/ama2006-124.394 -
Jornal de Pediatria 2023Meckel diverticulum (MD) is a common malformation of the digestive tract, often accompanied by serious complications. It is important to find safe and effective... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Meckel diverticulum (MD) is a common malformation of the digestive tract, often accompanied by serious complications. It is important to find safe and effective diagnostic methods for screening MD. The aim of this study was to evaluate the effectiveness of a technetium-99m (Tc-99m) scan for pediatric bleeding MD.
METHODS
The authors conducted a systematic review of studies published in PubMed, Embase, and Web of Science before 1 January 2023. Studies based on PICOS were included in this systematic review. The flow chart was made by PRISMA software. The quality of included studies was assessed by RevMan5 software (QUADAS-2: Quality Assessment of Diagnostic Accuracy Studies-2). The sensitivity, specificity, and other measurements of accuracy were pooled using Stata/SE 12.0 software.
RESULTS
Sixteen studies with 1115 children were included in this systematic review. A randomized-effects model was used for the meta-analysis because of significant heterogeneity. The combined sensitivity and specificity were 0.80 [Confidence Interval (95% CI, 0.73-0.86) and 0.95 (95% CI, 0.86-0.98)], respectively. The area under the curve (AUC) was 0.88 (95% CI, 0.85-0.90). Publication bias (Begg's test p = 0.053) was observed.
CONCLUSION
Tc-99m scan has high specificity, but moderate sensitivity, which is always influenced by some factors. Hence, the Tc-99m scan has some limitations in the diagnosis of pediatric bleeding MD.
Topics: Child; Humans; Technetium; Meckel Diverticulum; Radionuclide Imaging; Gastrointestinal Hemorrhage; Sensitivity and Specificity
PubMed: 37277097
DOI: 10.1016/j.jped.2023.03.009 -
Pathologica Feb 2022Congenital anomalies of the tubular gastrointestinal tract are an important cause of morbidity not only in infants, but also in children and adults. The gastrointestinal... (Review)
Review
Congenital anomalies of the tubular gastrointestinal tract are an important cause of morbidity not only in infants, but also in children and adults. The gastrointestinal (GI) tract, composed of all three primitive germ layers, develops early during embryogenesis. Two major steps in its development are the formation of the gut tube (giving rise to the foregut, the midgut and the hindgut), and the formation of individual organs with specialized cell types. Formation of an intact and functioning GI tract is under strict control from various molecular pathways. Disruption of any of these crucial mechanisms involved in the cell-fate decision along the dorsoventral, anteroposterior, left-right and radial axes, can lead to numerous congenital anomalies, most of which occur and present in infancy. However, they may run undetected during childhood. Therapy is surgical, which in some cases must be performed urgently, and prognosis depends on early diagnosis and suitable treatment. A precise pathologic macroscopic or microscopic diagnosis is important, not only for the immediate treatment and management of affected individuals, but also for future counselling of the affected individual and their family. This is even more true in cases of multiple anomalies or syndromic patterns. We discuss some of the more frequent or clinically important congenital anomalies of the tubular GI, including atresia's, duplications, intestinal malrotation, Meckel's diverticulum and Hirschsprung's Disease.
Topics: Digestive System Abnormalities; Humans; Intestinal Volvulus; Meckel Diverticulum; Prognosis
PubMed: 35212315
DOI: 10.32074/1591-951X-553 -
BMJ Case Reports Feb 2019
Topics: Aged; Hernia, Femoral; Humans; Male; Meckel Diverticulum
PubMed: 30824469
DOI: 10.1136/bcr-2018-228784 -
Chirurgia (Bucharest, Romania : 1990) 2016Meckel's Diverticulum is the most common congenital malformation of the gastrointestinal tract with a prevalence of 2 % in the general population, being twice as common...
Meckel's Diverticulum is the most common congenital malformation of the gastrointestinal tract with a prevalence of 2 % in the general population, being twice as common and symptomatic in males. Not seldom is the diagnosis made incidentally, upon laparotomy for other intra-abdominal conditions, namely acute appendicitis. Simple Diverticulectomy is the surgical treatment of choice. We present the case of S.M., a 38 year-old male who was admitted to the Surgery Department of the Bucharest Clinical Emergency Hospital for sudden onset of initially periumbilical pain, which later migrated and localized in the right iliac fossa (RIF) accompanied by vomiting after the onset of pain, approximately 24 hours prior to admission. Examination of the abdomen revealed localized peritoneal signs. An Alvarado score of 8 was calculated. A laparotomy for appendectomy was performed, upon which the sigmoid colon was found in the RIF, and an appendix of 10 cm in length was visualized in a subhepatic, ascendant position. At a distance of 90 cm from the ileocecal valve, a Meckel's Diverticulum with dimensions of 7/4 cm was discovered. A retrograde appendectomy was performed first, along with a simple diverticulectomy, with the use of a TA 30 mm stapler. The operative time was 90 minutes without intraoperative complications, and an uneventful postoperative recovery, culminating with discharge of the patient on the fifth postoperative day. Despite its high prevalence, Meckel's Diverticulum still represents a diagnostic challenge, especially in the adult population, notably in asymptomatic patients. Moreover, ectopic gastric or pancreatic tissue, present in 50% of the cases, leads to a vast array of differential diagnoses. Due to its numerous life-threatening complications such as bleeding, intestinal obstruction, volvulus, intussusception, diverticulitis, fistulization and perforation, accurate diagnosis and timely treatment is crucial.
Topics: Abdominal Pain; Acute Disease; Adult; Appendectomy; Appendicitis; Diagnosis, Differential; Diverticulitis; Emergencies; Humans; Incidental Findings; Male; Meckel Diverticulum; Surgical Stapling; Treatment Outcome; Vomiting
PubMed: 27452941
DOI: No ID Found