scholarly journals Meckel’s Diverticulum: Factors Associated with Clinical Manifestations

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Jeng-Jung Chen ◽  
Hung-Chang Lee ◽  
Chun-Yan Yeung ◽  
Wai-Tao Chan ◽  
Chuen-Bin Jiang ◽  
...  

Objectives. The purpose of this study was to investigate the clinical features of Meckel’s diverticula at different ages, genders, and pathology in order to serve as a reminder to clinicians when evaluating potential cases and to help obtain an early diagnosis. Methods. We collected information of patients with Meckel’s diverticulum diagnosed at Mackay Memorial Hospital in Taiwan from 1984 to 2009. After performing a thorough review of their charts, the clinical features of the Meckel’s diverticula were analyzed according to age groups, gender, and pathology. Result. A total of 126 patients, with 90 males and 36 females, were enrolled in this study. Seventy-five patients were symptomatic and 51 Meckel’s diverticula were found incidentally during surgery for other diseases. Among symptomatic patients, 39% of pediatric patients and 5% of adult patients had intestinal hemorrhage. Twenty-eight percent of pediatric patients and 67% of adult patients had inflammation of Meckel’s diverticulum. Forty-six percent of males and 16% of females had inflammation. Conversely, 27% of males and 58% percent of females had intestinal obstruction. When Meckel’s diverticulum had ectopic gastric mucosa, it tended to cause intestinal hemorrhage when the patient is young. Conclusions. Age, gender, and pathology affect the clinical presentations of Meckel’s diverticula.

2020 ◽  
pp. jim-2020-001581
Author(s):  
Chance S Friesen ◽  
Thomas Mario Attard ◽  
Maria Cole ◽  
Jay G Berry ◽  
Matt Hall

Meckel’s diverticulum (MD) is a well-defined diagnosis in children presenting with either bleeding or obstruction. Although anecdotally adult patients may present with complications from MD, their presentation seems to be different, with a reported predominance of non-bleed-related presentations. Reports in this population, however, are limited, and little is known of the epidemiology of MD in older patients. We performed a retrospective analysis of the Agency of Healthcare Research and Quality National Inpatient Sample of all US hospital discharges from 2012 to 2016. We identified patients with a primary discharge diagnosis of MD. Data were abstracted as raw numbers and population weighted rates of discharge with age group, income level, length of stay (LOS) and hospital charges as additional information. On average, 2030 individuals were discharged annually; most (71.1%) were adults (>18 years). Although MD was predominant in males in all age groups, the gender ratio decreased with older age categories from 3.5:1.0 (1–17 years) to 1.6:1.0 (65–84 years). LOS averaged 5.3 days with no clear relationship to other parameters. Median income category, however, closely correlated (R2=0.9996) with diagnosis in older age categories. MD may be significantly more prevalent in adult patients than was previously understood. Differences in gender preponderance suggest that gender may influence the pattern of presentation. Diagnosis in older individuals is closely associated with income or socioeconomic status but not hospital charges or LOS.


2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Hisham A. Almetaher ◽  
Mohammed Awad Mansour

Abstract Background Meckel’s diverticulum (MD) is the commonest congenital abnormality of the gastrointestinal tract that occurs in 2% of general population. It remains asymptomatic, but it may lead to life-threatening complications. These complications may be misdiagnosed with other gastrointestinal disorders like acute appendicitis, making its diagnosis challenging among pediatricians and pediatric surgeons. In this study, we reported five cases with different presentations of complicated MD in children. Results Five patients with different presentations of MD were reported during the period from January 2016 to January 2020. Patients’ demographics, clinical presentations, investigations, operative data, and postoperative outcome were recorded and analyzed. Conclusions The present study highlights different presentations of MD. Surgical interference is the main key of treatment of symptomatic MD either by wedge resection of a small base diverticulum or by resection anastomosis of the small intestine in wide base and inflamed diverticulum.


Author(s):  
Tatiana C R Senna ◽  
Maria Inês F Pimentel ◽  
Liliane F A Oliveira ◽  
Marcelo R Lyra ◽  
Mauricio N Saheki ◽  
...  

Abstract Background American tegumentary leishmaniasis (ATL) is a neglected disease with wide territorial distribution. Knowledge is scarce in children and adolescents. This study aims to compare the clinical features and response to antimony treatment in pediatric and adult patients with cutaneous leishmaniasis. Methods A retrospective cohort study was performed with 659 patients who attended a reference centre in Rio de Janeiro, Brazil, from 2000 to 2015. The pediatric cohort consisted of 131 (20%) patients and the adult cohort consisted of 528 (80%) patients. Results The epidemiological profile, antimony therapeutic response and incidence of adverse events (AE) were different in the pediatric cohort compared with the adult cohort. Mucosal form was less frequent in the pediatric cohort (RR:0.49, p=0.011). Lesions in the head, neck and trunk were more frequent in the pediatric cohort (RR:1.49, p=0.043). The effectiveness of antimony treatment was superior in the pediatric cohort (88.3% vs 76.6%) with a shorter healing time (RR:0.49, p=0.009). Pediatric patients had lower proportions of moderate to severe AE compared with adults (RR:0.45, p=0.027). Clinical AE predominated in the adult cohort (RR:0.40, p=0.000) and laboratory AE in the pediatric cohort (RR:1.50, p=0.023). Conclusions This study adds to the body of knowledge on differences that exist between different age groups in ATL.


2015 ◽  
Vol 76 (9) ◽  
pp. 2231-2236 ◽  
Author(s):  
Yuichiro OKUMURA ◽  
Susumu MIYAZAKI ◽  
Kazumasa FUJITANI ◽  
Hiroaki FUSHIMI ◽  
Katsuki DANNO ◽  
...  

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Kazuki Wakizaka ◽  
Lee Wee Khor ◽  
Kazuya Annen ◽  
Tsuyoshi Fukushima ◽  
Mitsuko Furuya ◽  
...  

Abstract Background The most common presentation of symptomatic Meckel’s diverticulum (MD) are intestinal obstruction, gastrointestinal hemorrhage, and inflammation of the MD with or without perforation. Intraperitoneal hemorrhage because of MD is extremely rare. We report a case of MD with intraperitoneal hemorrhage in a child detected with screening laparoscopy. Case presentation An 11-year-old girl presented to another hospital with lower abdominal pain and vomiting that lasted for 2 days. Acute appendicitis was suspected, and she was referred to our department. Abdominal enhanced computed tomography showed an abscess in the lower abdomen with ascites in the pelvis. She was diagnosed with a localized intra-abdominal abscess and the decision was made to treat with antibiotics. However, her abdominal pain worsened, with abdominal distension, tenderness and guarding. She was diagnosed with panperitonitis and the decision was made for surgery 5 h after admission. During surgery, laparoscopic observation from the umbilical region revealed 200 ml of fresh blood throughout the peritoneal cavity, originating from the mesentery of the ileum. MD was observed with bleeding from the surrounding mesentery. Small bowel resection was performed, and the patient was discharged on the 5th postoperative day. Pathological findings revealed an MD containing ectopic gastric mucosa and small intestinal ulcer perforation at the base of the MD. Conclusions We report an extremely rare case of an MD with intraperitoneal hemorrhage in a child. In pediatric cases, it is possible that perforation with ectopic gastric mucosa may cause massive bleeding because of rupture of the surrounding mesenteric blood vessels.


2018 ◽  
Vol 10 (5) ◽  
pp. 2881-2889 ◽  
Author(s):  
Jaehee Lee ◽  
Jae Kwang Lim ◽  
Eun Jin Kim ◽  
Deok Heon Lee ◽  
Yu Kyung Kim ◽  
...  

2017 ◽  
Vol 03 (02) ◽  
pp. E91-E92 ◽  
Author(s):  
Brian Malling ◽  
Andreas Karlsen ◽  
Jesper Hern

A Meckel’s diverticulum is a remnant of the vitelline duct, which leads to the formation of a true diverticulum containing all layers of the small intestine. The diverticulum can contain ectopic gastric, duodenal or pancreatic tissue and is the most common congenital anomaly of the gastrointestinal tract with estimates of prevalence ranging from 0.3% to 3%. The condition is usually clinically silent. In children the most common complication is gastrointestinal bleeding caused by ulceration due to the acid secretion by ectopic gastric mucosa.


2013 ◽  
Vol 33 (3) ◽  
pp. 227-229
Author(s):  
Raashid Hamid ◽  
Sajad A Wani ◽  
AH Shera ◽  
Sheikh Khurshid ◽  
NA Bhat ◽  
...  

Meckel’s Diverticulum (MD) is a frequent congenital anomaly of small bowel often difficult to diagnose. It is usually asymptomatic and can present as bleeding, obstruction and inflammation. We report a case of MD in a 3 year old male child, diagnosed by 99mTc pertechnetate scan and confirmed on laparotomy. Excised specimen revealed a large MD with multiple ileal ulcers, as a source of massive bleeding per rectum. The clinical features and need for early diagnosis and treatment are discussed. DOI: http://dx.doi.org/10.3126/jnps.v33i3.7802   J. Nepal Paediatr. Soc. 2013;33(3):227-229


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