scholarly journals A Rare Cause of Acute Abdomen: Perforation of Double Meckel’s Diverticulum

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
İlhan Tas ◽  
Serdar Culcu ◽  
Yigit Duzkoylu ◽  
Sadik Eryilmaz ◽  
Mehmet Mehdi Deniz ◽  
...  
Keyword(s):  
Acute Abdomen ◽  
Meckel’S Diverticulum ◽  
Ileocecal Valve ◽  
Rare Condition ◽  
Meckel's Diverticulum ◽  
Rare Entity ◽  
Lower Quadrant ◽  
X Ray ◽  
The Right ◽  
Right Lower Quadrant

Meckel’s diverticulum is the most common congenital anomaly of the gastrointestinal tract. In this report, we aimed to represent a case of intestinal perforation, caused by double Meckel’s diverticulum, which is a very rare entity in surgical practice. The patient was a 20-year-old Caucasian man, admitted to hospital with complaints of abdominal pain, nausea, and vomitting during the last 3 days. Physical examination indicated tenderness, rebound, and guarding in the right lower quadrant of abdomen. Abdominal X-ray revealed a few air-liquid levels in the left upper quadrant. In the operation, 2 Meckel’s diverticula were observed, one at the antimesenteric side, at 70 cm distance to the ileocecal valve, approximately in 3 cm size, and the other between the mesenteric and antimesenteric sides, approximately in 5 cm size. The first one had been perforated at the tip and wrapped with omentum. A 30 cm ileal resection, including both diverticula with end-to-end anastomosis, was performed. The diagnosis of symptomatic Meckel’s diverticulum is considerably hard, especially when it is complicated. Diverticulectomy or segmentary resections are therapeutic options. In patients with acute abdomen clinic, Meckel’s diverticulum and its complications should be kept in mind, and the intestines should be observed for an extra diverticulum for caution although it is a very rare condition.

scholarly journals Sonographic Detection of a Torsed Meckel’s Diverticulum Misinterpreted as Acute Appendicitis

2019 ◽  
Vol 3 (3) ◽  
pp. 278-281
Author(s):  
Justin Choi ◽  
Nicole Dorinzi ◽  
Justine Pagenhardt ◽  
Anthony Steratore ◽  
Melinda Sharon ◽  
...  
Keyword(s):  
Point Of Care ◽  
Meckel’S Diverticulum ◽  
Acute Onset ◽  
Meckel's Diverticulum ◽  
Point Of Care Ultrasound ◽  
Lower Abdomen ◽  
Lower Quadrant ◽  
Rebound Tenderness ◽  
The Right ◽  
Right Lower Quadrant

A 38-year-old female presented to the emergency department (ED) with acute-onset right lower quadrant abdominal pain following two days of nausea and vomiting. Physical examination revealed right lower quadrant tenderness to palpation, rebound tenderness, and guarding. Point-of-care ultrasound (POCUS) of the right lower abdomen was performed and interpreted as probable appendicitis. However, upon laparoscopic examination of the abdomen, a benign-appearing appendix was visualized. Further investigation revealed the source of the patient’s pain to be a torsed Meckel’s diverticulum. Although rare, a torsed and inflamed Meckel’s diverticulum can be visualized by POCUS in the ED without the need for further imaging or delay.

scholarly journals ABDOMEN AGUDO DE ETIOLOGÍA INUSUAL: DIVERTÍCULO DE MECKEL PERFORADO POR UNA ESPINA DE PESCADO.

2021 ◽  
Vol 32 (1) ◽  
Author(s):  
Iván René Cantos ◽  
Ronnal Patricio Vargas ◽  
Jorge Eduardo Vásconez ◽  
Rody Alejandro Mecías ◽  
Daysi Alejandra León ◽  
...  
Keyword(s):  
Foreign Body ◽  
Meckel’S Diverticulum ◽  
Laparoscopic Approach ◽  
Ileocecal Valve ◽  
Meckel's Diverticulum ◽  
Linear Stapler ◽  
Lower Quadrant ◽  
Computed Tomographic ◽  
Ectopic Tissue ◽  
Right Lower Quadrant

Meckel's diverticulum is the most common congenital malformation of the digestive tract; It has a prevalence that ranges from 0.3% - 2.9% in the general population according to different publications, its incidence is higher in males with a 1.5-4: 1 ratio. In general, they present an asymptomatic course throughout life, but it is estimated that 4.2% will have some associated complication, and 3% will require hospitalization and surgery. A 37-year-old male patient who presented with nonspecific abdominal pain, the physical examination revealed a painful abdomen in the mesogastrium and right lower quadrant, without signs of peritoneal irritation. Laboratory studies without alterations; as there was no improvement in the abdominal condition, it was complemented with a computed tomographic study, which showed a hyperdense linear image in the distal ileum in relation to a probable foreign body. A surgical resolution was decided using a laparoscopic approach; as laparoscopy equipment was not available, an infraumbilical laparotomy was performed. A foreign body was identified in relation to a fishbone that crosses Meckel's diverticulum at 80 cm from the ileocecal valve. A diverticulectomy with linear stapler was performed without complications, the histopathology reported Meckel's diverticulum without evidence of ectopic tissue, and he was discharged after 48 hours. Conclusions: the presence of a Meckel diverticulum as an etiology of an acute abdomen should be taken into account and be part of the differential diagnosis of pain in the right lower quadrant; foreign body perforation being rare.

scholarly journals Intussusception Secondary to a Meckel's Diverticulum in an Adolescent

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
John Morrison ◽  
Rebecca Jeanmonod
Keyword(s):  
Abdominal Pain ◽  
Meckel’S Diverticulum ◽  
Meckel's Diverticulum ◽  
Older Children ◽  
Lower Quadrant ◽  
Abdominal Emergency ◽  
Operative Findings ◽  
Underlying Pathology ◽  
Right Lower Quadrant ◽  
Older Child

A 13-year-old girl presented to the Emergency Department with vomiting and abdominal pain. On examination, she had only mild abdominal tenderness, but a mass was palpable in her right lower quadrant. Intussusception was diagnosed on ultrasound and confirmed on computed tomography (CT) scan, and operative findings revealed a jejunojejunal intussusception secondary to Meckel's diverticulum. Intussusception is a surgical abdominal emergency, which can present in all ages but is the most common reason for small bowel obstruction in childhood. It is a well-known cause of abdominal pain, vomiting, and bloody diarrhea in infancy but often not considered when evaluating the older child with similar symptoms. However, consideration of this diagnosis is important, as more than 1/3 of cases present beyond the age of 7. In older children, intussusception is more likely to be related to underlying pathology, such as Meckel's diverticulum, malignancy, or polyp. Intussusception should be on the differential in any patient with isolated abdominal complaints, and when it is diagnosed in an older child, it should be recognized that it is likely secondary to underlying pathology.

scholarly journals A Case Report of Idiopathic Omental Infarction in an Obese Child

2012 ◽  
Vol 2012 ◽  
pp. 1-2 ◽  
Author(s):  
Tomoyuki Tsunoda ◽  
Tsuyoshi Sogo ◽  
Haruki Komatsu ◽  
Ayano Inui ◽  
Tomoo Fujisawa
Keyword(s):  
Abdominal Pain ◽  
Acute Abdomen ◽  
Sudden Onset ◽  
Obese Children ◽  
Lower Quadrant ◽  
Omental Infarction ◽  
Rebound Tenderness ◽  
Enhanced Ct ◽  
The Right ◽  
Right Lower Quadrant

Omental infarction (OI) is a rare cause of acute abdomen in children. A 9-year-old girl was presented with sudden-onset intermittent right lower quadrant abdominal pain and fever (37.9°C). Physical examination revealed abdominal tenderness in the right lower quadrant with localized rebound tenderness which resembled acute appendicitis. She was obese and her BMI was on the 99th percentile. Computed tomography (CT) revealed a 5 cm ill-defined heterogeneous fatty mass with hyperattenuating streaks just beneath the abdominal wall. She was diagnosed as OI and treated conservatively with reduced meals and antibiotics. Her symptom resolved gradually and she was discharged on day 7 without complications. OI should be considered as a differential diagnosis for acute right-sided abdominal pain, especially in obese children. Enhanced CT is useful for differentiating OI from other conditions presenting with acute abdomen.

scholarly journals Perforation of a Meckel’s diverticulum secondary to chronic NSAID use: case report and review of the literature

2020 ◽  
Vol 7 (9) ◽  
pp. 3082
Author(s):  
Francisco Terrazas Espitia ◽  
David Molina Davila ◽  
Luis Villalobos Ramirez ◽  
Bruno Salazar Trujillo ◽  
Lucio Santos Moyron ◽  
...  
Keyword(s):  
Epigastric Pain ◽  
Iliac Fossa ◽  
Meckel’S Diverticulum ◽  
Ileocecal Valve ◽  
Acute Onset ◽  
Meckel's Diverticulum ◽  
Male Population ◽  
History Of ◽  
Heterotopic Tissue ◽  
The Right

Meckel´s diverticulum is an abnormality in the development of the gastrointestinal system, its origin and clinical significance was first described by Johan Friedrich Meckel in 1809. It is a remnant of the omphalomesenteric duct which is usually observed following the rule of 2’s, located 2 feet proximal to the ileocecal valve, before 2 years of age in approximately 2% of the population, and is twice as common in male population. It is considered a true diverticulum because it presents all the histopathological layers of the bowel; 6% of the cases present with heterotopic tissue, mainly pancreatic, gastric, colonic or jejunal. We present the case of a 37-year-old patient who presented with acute onset epigastric pain which migrated to the right iliac fossa, he had a history of chronic non-steroidal anti-inflammatory drugs (NSAIDs) usage for articular pain. He underwent abdominal contrast tomography (CT) scan with double iodine contrast enhancement, which revealed the presence of a perforated Meckel´s diverticulum in the antimesenteric portion of the terminal ileum. The patient underwent laparoscopic diverticulectomy with no complications and was discharged 72 hours after the procedure. Histopathological confirmation of a perforated meckel’s diverticulum with heterotopic gastric mucosa confirmed the clinical suspicion of perforation secondary to chronic NSAIDs usage.

CLINICAL CASE OF A MALIGNANT PECOMA OF THE LUNG

2019 ◽  
Vol 65 (5) ◽  
pp. 756-759
Author(s):  
Mikhail Postolov ◽  
Nadezhda Kovalenko ◽  
K. Babina ◽  
Stanislav Panin ◽  
Yelena Levchenko ◽  
...  
Keyword(s):  
Good Condition ◽  
Lung Neoplasm ◽  
Rare Condition ◽  
Epithelioid Cell ◽  
X Ray ◽  
Perivascular Epithelioid Cell ◽  
Mesenchymal Neoplasm ◽  
Preoperative Ct ◽  
Lymph Duct ◽  
The Right

Perivascular epithelioid cell tumor (PEComa) is a rare mesenchymal neoplasm characterized by expression of both mela-nocytic and smooth muscle markers. Only 10 primary malignant lung PEComas have been reported up to date. We report a 59-year-old male who presented with a lung neoplasm, found during the routine X-ray examination. Preoperative CT-scan revealed the 3,5-cm-sized mass, located at the border of the upper, middle and lower lobes of the right lung. Patient underwent a thoracotomy, resection of the upper, middle and lower lobes of the right lung accompanied with mediastinal lymphadenectomy. After surgery, chylothorax was revealed. Conservative treatment was unsuccessful, so we performed laparoscopic clipping of the thoracic lymph duct. Patient was dismissed from hospital on the 10-th day after the second operation in good condition. In this report, we intend to increase the limited knowledge relating to natural history and optimal treatment of such a rare condition as a primary malignant lung PEComa.

scholarly journals Axial torsion of Meckel’s diverticulum causing acute peritonitis in the first trimester of pregnancy: a case report

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Hiromitsu Nagata ◽  
Hiroyasu Nishizawa ◽  
Susumu Mashima ◽  
Yasuyuki Shimahara
Keyword(s):  
Clinical Diagnosis ◽  
Meckel’S Diverticulum ◽  
Ileocecal Valve ◽  
First Trimester ◽  
Meckel's Diverticulum ◽  
Ileocecal Resection ◽  
Bowel Loop ◽  
Axial Torsion ◽  
First Trimester Of Pregnancy ◽  
In Pregnancy

Abstract Background Meckel’s diverticulum is considered the most prevalent congenital anomaly of the gastrointestinal tract. Approximately 4% of patients are symptomatic with complications such as bleeding, intestinal obstruction, and inflammation, while axial torsion of Meckel’s diverticulum is rare, particularly in pregnancy. Case presentation A 31-year-old woman in week 15 of pregnancy complained of epigastric pain, nausea and vomiting. Clinical diagnosis was severe hyperemesis gravidarum. Because the symptoms persisted during hospitalization, CT was performed and revealed dilated small bowel loops with multiple air-fluid levels. In the right mid-abdomen, there was a large part of air containing a cavity connected to the small intestine, which was considered a dilated bowel loop. Emergency laparotomy was performed and axial torsion of a large Meckel’s diverticulum measuring 11 cm was found at a few centimeters proximal to the ileocecal valve. Ileocecal resection including Meckel’s diverticulum was performed. The postoperative course was uneventful. At 40 weeks gestation, she had vaginal delivery of normal baby. Conclusion The physiological and anatomical changes in pregnancy can make a straightforward clinical diagnosis difficult. Prompt diagnosis and management were needed in order to avoid significant maternal and fetal risks. The use of imaging examinations, especially CT examination, with proper timing may be helpful to prevent delay in diagnosis and surgical intervention. Here, we report the case of a patient with axial torsion of Meckel’s diverticulum in pregnancy. To our knowledge, axial torsion of Meckel’s diverticulum in the first trimester of pregnancy has not been reported in the English medical literature.

scholarly journals Intestinal obstruction caused by pericecal internal herniation

2020 ◽  
Vol 2020 (2) ◽  
Author(s):  
Floris B Poelmann ◽  
Ewoud H Jutte ◽  
Jean Pierre E N Pierie
Keyword(s):  
Abdominal Pain ◽  
Intestinal Obstruction ◽  
Acute Abdominal Pain ◽  
Treatment Preference ◽  
Treatment Modalities ◽  
Internal Herniation ◽  
Lower Quadrant ◽  
Surgical History ◽  
The Right ◽  
Right Lower Quadrant

Abstract Intestinal obstruction caused by pericecal internal herniation are rare and only described in a few cases. This case describes an 80-year-old man presented with acute abdominal pain, nausea and vomiting, with no prior surgical history. Computed tomography was performed and showed a closed loop short bowel obstruction in the right lower quadrant and ascites. Laparoscopy revealed pericecal internal hernia. This is a viscous protrusion through a defect in the peritoneal cavity. Current operative treatment modalities include minimally invasive surgery. Laparoscopic repair of internal herniation is possible and feasible in experienced hands. It must be included in the differential diagnoses of every patient who presents with abdominal pain. When diagnosed act quick and thorough and expeditiously. Treatment preference should be a laparoscopic procedure.

Appendicitis: a rare adverse event in colonoscopy

2021 ◽  
Vol 14 (7) ◽  
pp. e242523
Author(s):  
Samer Al-Dury ◽  
Mohammad Khalil ◽  
Riadh Sadik ◽  
Per Hedenström
Keyword(s):  
Emergency Department ◽  
Adverse Event ◽  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Physical Examination ◽  
De Novo ◽  
Perforated Appendicitis ◽  
Lower Quadrant ◽  
The Right ◽  
Right Lower Quadrant

We present a case of a 41-year-old woman who visited the emergency department (ED) with acute abdomen. She was diagnosed with perforated appendicitis and abscess formation on CT. She was treated conservatively with antibiotics and discharged. On control CT 3 months later, the appendix had healed, but signs of thickening of the terminal ileum were noticed and colonoscopy was performed, which was uneventful and showed no signs of inflammation. Twelve hours later, she developed pain in the right lower quadrant, followed by fever, and visited the ED. Physical examination and blood work showed signs consistent with acute appendicitis, and appendectomy was performed laparoscopically 6 hours later. The patient recovered remarkably shortly afterwards. Whether colonoscopy resulted in de novo appendicitis or exacerbated an already existing inflammation remains unknown. However, endoscopists should be aware of this rare, yet serious complication and consider it in the workup of post-colonoscopy abdominal pain.

scholarly journals Ectopic decidua of the appendix: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Manabu Kaneko ◽  
Hiroaki Nozawa ◽  
Hirofumi Rokutan ◽  
Koji Murono ◽  
Tetsuo Ushiku ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Acute Appendicitis ◽  
Rare Entity ◽  
Lower Quadrant ◽  
Case Presentation ◽  
Decidual Tissue ◽  
Abdominal Symptoms ◽  
History Of ◽  
Myxoid Degeneration ◽  
Right Lower Quadrant

Abstract Background Ectopic decidua is the presence of decidual tissue outside the uterus. Ectopic decidua of the appendix is a rare entity that can present with abdominal symptoms mimicking appendicitis. We report a case of a 39-year-old female patient at 27 weeks gestational age with a 2-day history of right lower quadrant abdominal pain. Case presentation The patient was referred to our hospital with suspicion of either acute appendicitis or threatened rupture of the uterus, the latter of which was considered unlikely following close examination. Therefore, she underwent emergency appendectomy via laparotomy. Microscopic examination revealed decidual tissue with myxoid degeneration in the subserosal layer of the tip side of the appendix, without endometriosis, which was compatible with ectopic decidua (deciduosis). Conclusions Because it is extremely difficult to distinguish ectopic decidua of the appendix from acute appendicitis, even with various imaging modalities, we should be aware that ectopic decidua of the appendix is a differential diagnosis for acute appendicitis in pregnant women.

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