Acute intussusception secondary to Meckel's diverticulum

Le diverticule de Meckel (DM) est une persistance du canal omphalo-mésentérique. Il est souvent asymptomatique, mais peut être responsable de complications diverses avec des tableaux cliniques variables notamment chez l'enfant. Nous avons réalisé une étude rétrospective au Service de Chirurgie Pédiatrique du CHU Hassan II de Fès (Maroc), sur les DM compliqués chez l'enfant dans le but de décrire les aspects cliniques, radiologiques et thérapeutiques. Sur une période de 10 ans (janvier 2009- décembre 2018), 18 enfants (15 garçons et 3 filles) âgés de 1 jour à 15 ans (âge moyen de 5 ans) ont été opérés pour une complication du DM. L'invagination intestinale aigue et l'occlusion intestinale étaient les complications les plus fréquentes. Les autres complications décrites sont l'infection du DM (1 cas) et l'hémorragie digestive (2 cas). Deux formes néonatales rares ont été décrites (occlusion néonatale et fistule sur omphalocèle). L'imagerie basée sur la radiographie de l'abdomen sans préparation (ASP), l'échographie et la tomodensitométrie (TDM) abdominale n'ont objectivé le DM en aucun cas. La scintigraphie a été réalisée pour les 2 cas ayant une rectorragie et elle a permis de faire le diagnostic du DM dans un cas. Trois patients ont été opérés par laparoscopie avec résection du DM avec anastomose intestinale par out-laparoscopie. Les autres patients ont été opérés par laparotomie. L'iléostomie a été réalisée dans un cas suivi d'un rétablissement secondaire. L'évolution était bonne pour tous les patients hormis un cas de lâchage d'anastomose. Sur le plan anatomo-pathologique, deux cas d'hétérotopie ont été notés.

Intussusception due to invaginated Meckel's diverticulum after previous appendectomy

In children, 90% cases of intussusception are idiopathic and the remaining 10% are attributed to underlying diseases (most commonly due to Meckel's diverticulum, polyps then either duplication cyst or mesentery cysts, and rarely due to Burkitt's lymphoma). The occurrence of acute intestinal intussusception caused by Burkitt's lymphoma in children under the age of 5 is exceedingly rare. Burkitt's lymphoma presents with diverse clinical manifestations, often leading to the identification of an abdominal tumor in pediatric patients. This highly aggressive and rapidly proliferating neoplasm can induce indirect symptoms due to compression or direct involvement of the intestinal lumen, resulting in intussusception. Herein, we present a case report of ileocolic-type intussusception in a 2-year-old boy, which was attributed to the coexistence of Burkitt's lymphoma and Meckel's diverticulum. Notably, this patient exhibited atypical clinical features for Burkitt's lymphoma and did not belong to the high-risk demographic associated with this rare disease. Furthermore, this case represents a unique combination involving the most prevalent cause of Meckel's diverticula and the rarest etiology of Burkitt's lymphoma.

A SURVEY of the literature reveals a wide difference between the classical type of acute intussusception and that initiated by Meckel's diverticulum. To determine the nature, extent, and explanation of these dissimilarities, all cases of the Meckel's diverticulum type of intussusception in the English-speaking literature since Harkins' 1 original report in 1933 have been reviewed. The disparities were found to pertain to age incidence, symptomatology, clinical and surgical findings, and mortality. Our interest in this subject was stimulated by a relatively high incidence of Meckel's diverticulum in a series of 116 cases of acute intussusception 2 and by the high morbidity and mortality in these particular cases. Some manifest differences between adult and pediatric patients in the Meckel's diverticulum variety of intussusception are outlined by a brief presentation of nine cases of this syndrome seen in St. Louis Children's Hospital from 1934 to 1951. PREVIOUS OBSERVATIONS Intussusception is not a

Summary:Heterotopic gastric mucosa (HGM) may be found anywhere in the gastrointestinal tract, most often in a Meckel's diverticulum. Approximately 30 cases of HGM, located in the small bowel beyond the ligament of Treitz and not associated with a Meckel's diverticulum, have been reported. They were most often revealed by intestinal intussusception, occasionally by perforation of an intestinal ulcer or intestinal bleeding. We report a 4‐year‐old boy who had three attacks of acute intestinal intussusception over a 5‐month period resulting in surgery. Both physical examination and barium examination of the small bowel and large intestine were found to be normal between attacks. Peroperative palpation of the small bowel was normal during the three laparotomies. During the third operation, he underwent an intraoperative endoscopy (IOE), which revealed a polypoid mass 2 cm in diameter and 0.5 cm in height, 40 cm proximal to the ileocaecal valve. Histologic examination showed HGM with fundic glands, and chief and parietal cells. This case emphasizes the interest of IOE, the main indications of which are the localization of unknown sites of gastrointestinal bleeding and the search for hamartomatous polyps of the Peutz‐Jeghers syndrome for polypectomy and/or segmental resection.

Journal Article Acute intussusception due to inverted Meckel's Diverticulum Get access James C Gillies James C Gillies Hackney Hospital, London Search for other works by this author on: Oxford Academic Google Scholar British Journal of Surgery, Volume 32, Issue 126, October 1944, Pages 328–329, https://doi.org/10.1002/bjs.18003212621 Published: 06 December 2005

Heterotopic gastric mucosa (HGM) may be found anywhere in the gastrointestinal tract, most often in a Meckel's diverticulum. Approximately 30 cases of HGM, located in the small bowel beyond the ligament of Treitz and not associated with a Meckel's diverticulum, have been reported. They were most often revealed by intestinal intussusception, occasionally by perforation of an intestinal ulcer or intestinal bleeding. We report a 4-year-old boy who had three attacks of acute intestinal intussusception over a 5-month period resulting in surgery. Both physical examination and barium examination of the small bowel and large intestine were found to be normal between attacks. Peroperative palpation of the small bowel was normal during the three laparotomies. During the third operation, he underwent an intraoperative endoscopy (IOE), which revealed a polypoid mass 2 cm in diameter and 0.5 cm in height, 40 cm proximal to the ileocaecal valve. Histologic examination showed HGM with fundic glands, and chief and parietal cells. This case emphasizes the interest of IOE, the main indications of which are the localization of unknown sites of gastrointestinal bleeding and the search for hamartomatous polyps of the Peutz-Jeghers syndrome for polypectomy and/or segmental resection.

This study aims to retrospectively analyze the epidemiological and clinical characteristics of acute intussusception in a tertiary-care pediatric hospital in China over 4 years and evaluate the effectiveness and recurrence of fluoroscopy-guided pneumatic reduction (FGPR) and ultrasound-guided hydrostatic reduction (UGHR). This retrospective study was conducted from January 2019 to December 2022 involving children admitted and managed for acute intussusception in a tertiary-care pediatric hospital in China. The epidemiology, clinical features, and therapeutic effects were analyzed using IBM SPSS Statistics 20.0. The study included 401 boys (68.43%) and 185 girls (31.57%) aged from 2 months to 12 years. The most common symptoms reported were abdominal pain or paroxysmal crying (95.73%), vomiting (45.39%), and bloody stool (7.34%). Vomiting and bloody stool became atypical with increasing age (P < 0.001). The total success cases of reduction accounted for 563 cases (96.08%), and the recurrent cases accounted for 71 cases (12.12%). No significant difference was observed in the success or recurrence rates between FGPR and UGHR (P > 0.05). Abdominal pain was an independent protective factor for successful enema (P < 0.01, OR = 72.46), while bloody stool (P < 0.01, OR = 0.06) and older age were independent risk factors (P < 0.001, OR = 0.51). Of the 71 patients with recurrent intussusception, 29 were successfully reduced by enema, and the other 23 required surgical reduction. Twelve of the surgical cases were secondary intussusception, including three cases of Meckel's diverticulum, five cases of polyps, and four cases of non-Hodgkin lymphoma. The epidemiological characteristics of children with intussusception in Xiamen showed peculiarity with a higher male-to-female ratio, older age at diagnosis, and no significant seasonality. Both FGPR and UGHR were effective and safe for intussusception, and surgical reduction was essential for patients with failed enema reduction.

Chronic primary intussusception in an infant

Objective To evaluate the feasibility of open reduction of pediatric intussusception through inferior umbilical skin fold incision. Methods During June 2011 and November 2013, 26 cases of acute pediatric intussusceptions underwent open reduction through inferior umbilical skin fold incision. The mean age was 11.2 (3-28) months. The time from initial symptom to hospitalization was within 48 hours. Air enema was performed but failed in reduction. The surgical incision was arc-shaped along inferior umbilical skin fold. Distal ileum was extracted until intussusception part came under the incision. Then right finger was extended into abdominal cavity for intussusception reduction with the assistance of both hands outside abdominal wall. Results Twenty-five cases of intussusceptions were successfully reduced. The average operative duration was 29 min. One case required incision extension by 2 cm because of reduction difficulty. And another 1 case of Meckel's diverticulum was intraoperatively removed. Except for 1 case of fat liquefaction, there was no occurrence of such complications as infection, dehiscence or enterobrosis. After 1 month, the scars were invisible within the fold of navel skin.The surgical indications are for children with stable signs and a short onset time. Most cases of acute intussusception may be managed by open reduction through inferior umbilical skin fold incision. With only a small incision, it has fewer postoperative complications. For more difficult cases, proper extension of incision may achieve reduction without higher risk or complexity. Conclusions The surgical indications of open recluction through inferion umbibical skin fold incision are for children with stable signs and a short onset time. Most cases of acute intussusception may be managed by open reduction through inferior umbilical skin fold incision. With only a small incision, it has fewer postoperative complications. For more difficult cases, proper extension of incision may achieve reduction without higher risk or complexity. Key words: Intussusceptions; Digestive system surgical procedures; Feasibility studies

Acute intussusception on Meckels diverticulum (MD) is a rare cause of abdominal pain requiring emergency surgery. The aim of this study, is to provide an adequate level of clinical knowledge

Chronic intussusception as a cause of persistent abdominal pain in children is often an overlooked diagnosis. Here we present an eight-year-old boy, who at the age of three years had an acute intussusception reduced hydrostatically with barium and who subsequently had been extensively investigated both in Wales and in Switzerland, for persistent colicky abdominal pain. He was found to have chronic intussusception, with a Meckel's diverticulum being the cause of his symptoms.