Meckel's Diverticulum Presenting Research Articles

Meckel's diverticulum presenting with intestinal occlusion due to internal hernia

Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal system. Its incidence is approximately 0.3% to 3% of the population. It is located between 30 and 150 cm from the ileocecal valve. Up to 4% present with complications such as haemorrhage, diverticulitis, perforation, and intestinal obstruction. Clinical record of a patient admitted to the emergency room of an IMSS hospital in Ciudad Juárez, including clinical symptoms, imaging, surgical management and pathological anatomy. Patient presented to the emergency room with a clinical and imaging picture of intestinal obstruction. An exploratory laparotomy was performed, finding an internal hernia secondary to adhesions generated between a Meckel's diverticulum to the right mesocolon. Meckel's diverticulitis is a differential diagnosis to consider in young patients presenting with intestinal obstruction, since its early treatment reduces morbidity.

Meckel's diverticulum presenting as acute abdomen.

Meckel's diverticulum presenting as acute abdomen.

Different clinical symptoms and surgical treatment of Meckel's diverticulum in children

Objective: Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract and is usually identified incidentally during surgery for other reasons, upon radiological workup while investigating another disease or during autopsy. Among certain major symptoms of Meckel's diverticulum include gastrointestinal bleeding, volvulus, diverticulitis, intussusception, Littre's hernia or stool discharge from the umbilicus. In this study, we examined pediatric patients who were operated on for Meckel's diverticulum presenting with different clinical symptoms.
 Methods: The files of pediatric patients who were operated for Meckel's diverticulum in the pediatric surgery clinic between July 2002 and July 2017 were retrospectively reviewed. Patients who underwent incidental diverticulectomy were excluded from the study.
 Results: The 47 patients included in the study were 34 boys, 13 girls, and their mean age was 4.8 (1 day, 16 years). 49% of the patients were younger than 2 years old. The most common symptom observed in the patients was abdominal pain (63.8%). The most common indication for surgery was intestinal obstruction (53.2%). Intussusception was the cause in 64% of the patients in whom intestinal obstruction was the initial diagnosis. We detected gastrointestinal (GI) bleeding complaint in 12.8% of the patients. Segmentary bowel resection (46.8%) was the most common surgical procedure. In the pathological examination, ectopic tissue was found in 27 (57.4%) pathological specimens. While postoperative complications developed in 9 patients, 4 patients were treated conservatively and 5 patients were treated surgically.
 Conclusion: Establishing a preoperative diagnosis of Meckel's diverticulum may be difficult non other than rectal bleeding with currant jelly stool. In symptomatic Meckel's diverticulum, simple diverticulectomy, wedge resection or segmental bowel resection should be planned according to the complication caused by the diverticulum.

Concurrent intestinal malrotation and Meckel's diverticulum presenting as acute intestinal obstruction in an adult

Intestinal malrotation is the partial or complete failure of rotation of midgut around the superior mesenteric artery, while Meckel’s diverticulum is the remnant of vitellointestinal duct and concurrence of these congenital abnormalities in an adult is considered a rarity. Till date only 3 cases of concurrent intestinal malrotation and Meckel's diverticulum have been reported. We report a 18 years male who presented with a 3 day history of abdominal pain, bilious vomiting, obstipation and chronic abdominal pain on and off since 3 years of age. During the last episode which occurred 1 year back, he was diagnosed with intestinal malrotation with subacute intestinal obstruction and was treated conservatively. Examination revealed the presence of signs of peritonitis. After resuscitation, CECT abdomen was taken which showed dilated small bowel loops in the subhepatic region associated with malrotation. Emergency laparotomy revealed a Ladd's band below which the gangrenous small bowel loops 150 cm from the duodenojejunal (flexure until 5 cm proximal to the ileocecal junction) were found herniating into the subhepatic region with a Meckel’s diverticulum and a right sided DJ flexure. We proceeded with the band release and resection of gangrenous bowel followed by proximal jejunostomy with distal ileostomy. HPE was consistent with Meckel’s diverticulitis without any ectopic gastric or pancreatic mucosa. Ostomy reversal was done after 8 weeks. Patient had an uneventful postoperative recovery during both the admissions and he is on regular follow-up now.

Obstructing Meckel's diverticulum associated with Infantile Hypertrophic Pyloric Stenosis

Infantile Hypertrophic Pyloric Stenosis (IHPS) with Meckel's diverticulum presenting as an intraluminal cyst is a very rare presentation. We are reporting a case presenting with persistent non-bilious vomiting after each feed. Exploration revealed IHPS with incidental finding of intraluminal cyst at Meckel's diverticulum. • IHPS is the most common condition which requires surgical intervention within the first few weeks of life. • Presents with non-bilious vomiting. • Ramstedt's pyloromyotomy is operative procedure of choice. • Association of IHPS with other anomalies are very rare.

Re: Adenocarcinoma in a Meckel's diverticulum presenting as a phlegmon: a case report and a review of the literature

Re: Adenocarcinoma in a Meckel's diverticulum presenting as a phlegmon: a case report and a review of the literature

Meckel's diverticulum presenting with obstruction of appendix and small bowel obstruction: A case report

Meckel's diverticulum presenting with obstruction of appendix and small bowel obstruction: A case report

Antenatal Perforation of Meckel's Diverticulum Presenting as Meconium Peritonitis : Case Report and Literature Review

Antenatal Perforation of Meckel's Diverticulum Presenting as Meconium Peritonitis : Case Report and Literature Review

Perforation of Meckel diverticulum presenting with acute appendicitis

Meckel diverticulum is the most common congenital structural abnormality of the gastrointestinal tract. In 1809, Johann Friedrich Meckel first described its embryological origin. Between 2% and 4% of people may have Meckel diverticulum and 4-6% of them suffer from complications [1]. Meckel diverticulitis is usually confused with acute appendicitis and perforation with peptic ulcer perforation. We report a case which was clinically diagnosed as acute appendicitis which turned out to be perforation of a Meckel diverticulum, with inflammation of the appendix. This diagnostic and therapeutic dilemma of the case gives us an opportunity to report it as a case of interest. The Sri Lanka Journal of Surgery 2014; 32(4): 28-29

腹腔内出血で発症した成人Meckel憩室の1例

症例は43歳の男性で，心窩部痛が増悪し当院を紹介受診した．CTで原因不明の腹腔内出血を疑い，緊急手術を施行した．Meckel憩室を認め，その漿膜側からの出血源を同定し，同部位を含めた小腸部分切除術を行った．切除標本所見ではMeckel憩室内に異所性粘膜や腫瘍性病変は認めなかったが，炎症による憩室内圧の上昇により漿膜および漿膜下の血管が破綻したことで腹腔内出血を引き起こしたと類推された．Meckel憩室は多くが無症状で経過するが，一部では消化管出血・腸閉塞・憩室炎などの症状を認める．自験例のように穿孔や腫瘍を伴わずに腹腔内出血を起こすことは極めてまれな病態であるが，迅速な外科的加療が必要な病態であるため報告する．

Phytobezoar at the Meckel′s diverticulum presenting as small bowel obstruction: A rare case

Meckel's diverticulum occurs in about 1-3% of the general population. The majority of them are asymptomatic and incidentally identified at laparotomy. The most common complication due to Meckel's diverticulum in adults is intestinal obstruction. Phytobezoar is a concretion of poorly digested fruit and vegetable fibres that is found in the stomach commonly causing symptoms varying from dyspepsia to epigastric mass. Phytobezoars can rarely cause small intestinal obstruction. Herein, we have reported a case of phytobezoar in Meckel's diverticulum presenting as small bowel obstruction in a 38-year-old female.

Perforated meckel's diverticulum presenting as a hematocele on scrotal sonography

Hemorrhage from ectopic gastric mucosa is the most common presenting symptom of Meckel's diverticulum. Diverticular perforation, although rare, is a potentially life-threatening complication. Various imaging modalities can aid in the preoperative detection of Meckel's diverticulum. We report the sonographic findings of a hematocele as the heralding sequela of a perforated Meckel's diverticulum in an 11-month-old boy.

Unique Presentation of Meckel Diverticulum in the Form of Cocoon Managed Successfully by Laparoscopic Surgery

We report a case of complicated Meckel diverticulum presenting with subacute intestinal obstruction in a 21-year-old man managed successfully by laparoscopic surgery. Despite a diagnostic laparoscopy and laparotomy performed elsewhere in the past, main pathology was missed. Diagnostic laparoscopy in our center revealed a fusiform mass arising from terminal ileum, which was treated by laparoscopic-assisted resection and end-to-end ileo-ileal anastomosis. Gross and microscopic examination revealed an encapsulated localized cocoon containing 40 cm of ileum entangled around an inflamed Meckel diverticulum. His intestinal obstruction and hematochezia got relieved.

Perforated Meckel's diverticulum presenting with combined bowel and urinary obstruction and mimicking Crohn's disease: a case report

IntroductionMeckel's diverticulum is a common congenital anomaly of the gastrointestinal tract, but is an uncommon cause of serious complications in adults. Although cases of patients with hemorrhage, bowel obstruction or perforation associated with Meckel's diverticulum have been reported, there have been no prior reports of patients with combined urinary and bowel obstruction due to abscess formation.Case presentationWe describe the case of a 21-year-old man with a history of recurrent papillary thyroid cancer, but no prior abdominal surgeries, who presented with a one-month history of rectal pain and new-onset obstipation with urinary retention. He reported night sweats and weight loss, and had a second-degree relative with known Crohn's disease. A digital rectal examination was notable and revealed marked tenderness with proximal induration. A computed tomography scan of the patient's abdomen revealed a large, complex, circumferential perirectal abscess compressing the rectal lumen and base of the urinary bladder, associated with terminal ileal thickening and an ileocecal fistula. A flexible sigmoidoscopy with an endorectal ultrasound scan displayed a complex abscess with extensive mucosal and surrounding inflammation. An exploratory laparotomy revealed a Meckel's diverticulum with a large perforation at its base, positioned near the ileocecal fistula and immediately superior to the perirectal abscess. The section of small bowel containing the Meckel's diverticulum, the terminal ileum, and the cecum, were all resected, and the abscess was debrided.ConclusionsPre-operative diagnosis of Meckel's diverticulum can be difficult. If the nature of the complication makes ultimate surgical management likely, an early laparoscopic or open exploration should be performed to prevent the morbidity and mortality associated with late complications.

Primary adenocarcinoma of the Meckel's diverticulum presenting with small bowel obstruction: a case and brief review of the literature

Tumours of the Meckel's diverticulum are uncommon, with carcinoid tumours being the commonest type. Primary adenocarcinomas are extremely rare, but when seen are from gastric or pancreatic heterotopic cells. We report a case of primary intestinal adenocarcinoma arising in a Meckel's diverticulum in a 36 year old man, presenting with small bowel obstruction. The patient had a successful outcome following surgical resection.

Synchronous Meckel's diverticulum and gastrointestinal stromal tumour presenting as acute bleeding

A 34-year-old Caucasian male presented at our Emergency epartment with severe abdominal pain of increase intenity and melena. Oesophagogastroduodenoscopy (EGDS) showed aemorrhagic gastritis, whereas ultrasonography demonstrated a yperechoic mass of 5 cm×5 cm in diameter located at the left liac fossa, apparently separated from the urinary bladder. Multietector CT angiography (MDCTA) confirmed the presence of a ound, well demarcated, non-homogeneous mass adjacent to the rinary bladder and to the small bowel (arrows, Fig. 1). There were o CT signs of invasion with regard to the surrounding adipose issue and the urinary bladder.

A case of intussuscepted Meckel’s diverticulum

We report colonoscopic features of an intussuscepted Meckel's diverticulum, presenting with hematochezia. A 35-year-old woman presented to the emergency room with acute onset, transient, sharp, severe epigastric pain that began 6 h earlier. Colonoscopy revealed a reddish, soft, fist-sized polypoid lesion in the terminal ileum. The lesion was misinterpreted as a hematoma by an inexperienced endoscopist. The patient began to complain of intermittent, severe periumbilical pain following the colonoscopic examination. Subsequent computed tomography showed an enteric intussusception. An exploratory laparotomy revealed an intussuscepted Meckel's diverticulum, with transmural infarction. Colonoscopy was of little use in assessing the intussusception. However, colonoscopic examination may be performed initially, especially in an intussuscepted Meckel's diverticulum presenting with hematochezia. Endoscopists should note the endoscopic features of an intussuscepted Meckel's diverticulum.

P-009 Antenatal Perforation of Meckel's Diverticulum Presenting as Meconium Peritonitis : Case Report and Literature Review(Poster Presentation International Session 2,Better Life for Sick Children, Better Future for Pediatric Surgery,the 45th Annual Meeting of Japanese Society of Pediatric Surgeons)

P-009 Antenatal Perforation of Meckel's Diverticulum Presenting as Meconium Peritonitis : Case Report and Literature Review(Poster Presentation International Session 2,Better Life for Sick Children, Better Future for Pediatric Surgery,the 45th Annual Meeting of Japanese Society of Pediatric Surgeons)

Case report: Concurrent congenital complete atrioventricular block, Meckel's diverticulum and cerebral palsy in a 19-year-old male

A case report is described of a patient with cerebral palsy and Meckel's diverticulum presenting with congenital atrioventricular (AV) block. There is limited information of congenital heart block in adults, because most literature has been devoted to congenital heart block in childhood. This unique case is discussed with other patient groups' with congenital AV block. Long-term follow-up of congenital heart block is reviewed together with the concept of prophylactic pacemaker placement in symptom-free adults.

Leiomyoma Of Meckel's Diverticulum Presenting As Acute Abdomen

Leiomyoma Of Meckel's Diverticulum Presenting As Acute Abdomen