Inverted Meckel's diverticulum associated with heterotopic pancreatic tissue causing intestinal obstruction: a case report

Abstract Background Meckel’s diverticulum is the most frequent congenital anomaly of the gastrointestinal tract. It can invert or invaginate into the small intestine lumen. It is usually associated with heterotopic tissue elements. Case presentation We present a case of inverted Meckel's diverticulum, clinically and radiologically diagnosed as intestinal obstruction due to intussusceptions. The diagnosis was suspected due to target sign shown on radiological examination. Pathologically, it was inverted Meckel's diverticulum obstructing the lumen in parallel plan mimicking the telescoping appearance, with heterotopic pancreatic tissue formed of exocrine and ductal components only. Conclusions Inverted Meckel’s diverticulum may present by vague symptoms and may simulate other causes of intestinal obstruction.

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Littre Hernia: A Rare Case of an Incarcerated Meckel’s Diverticulum

Ultrasound International Open ◽

10.1055/s-0043-102179 ◽

2017 ◽

Vol 03 (02) ◽

pp. E91-E92 ◽

Cited By ~ 5

Author(s):

Brian Malling ◽

Andreas Karlsen ◽

Jesper Hern

Keyword(s):

Congenital Anomaly ◽

Small Intestine ◽

Rare Case ◽

Meckel’S Diverticulum ◽

Pancreatic Tissue ◽

Meckel's Diverticulum ◽

Ectopic Gastric Mucosa ◽

Common Complication ◽

Vitelline Duct ◽

Littre Hernia

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.

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Heterotopic Pancreas as Lead Point in Intussusception: New Variant of Vitellointestinal Tract Malformation

Pediatric and Developmental Pathology ◽

10.1007/s100249900136 ◽

1999 ◽

Vol 2 (4) ◽

pp. 367-370 ◽

Cited By ~ 18

Author(s):

Robin Abel ◽

Charles E. Keen ◽

John B. Bingham ◽

John Maynard ◽

Meena R. Agrawal ◽

...

Keyword(s):

Small Intestine ◽

Meckel’S Diverticulum ◽

Pancreatic Tissue ◽

Heterotopic Pancreas ◽

Meckel's Diverticulum ◽

Ectopic Gastric Mucosa ◽

Lead Point ◽

Heterotopic Pancreatic Tissue ◽

New Variant ◽

Acinar Tissue

Two cases of intussusception are reported with heterotopic pancreatic tissue attached to and draining into the ileum. The first patient, a boy aged 16 months, presented with ileoileal intussusception. The diagnosis was confirmed on ultrasound scan. Laparotomy and resection were performed. A 12-mm nodule of heterotopic pancreatic tissue was identified in the ileal serosa at the apex of the intussusceptum, fully formed with acinar tissue, islets, and draining duct. The second patient, also a boy aged 16 months, presented with obstructed ileocolic intussusception in which the lead point at surgery resembled a Meckel's diverticulum. Histopathology revealed a similar 10-mm nodule of fully formed pancreatic tissue in the ileal serosal tissues, with some acinar tissue extending through the wall of the intestine alongside ductal structures. In both cases there was ectopic gastric mucosa either in the distal part of the draining duct or in the small intestine itself at the opening. Heterotopic pancreas is a rare cause of intussusception. We propose that this lesion is of vitellointestinal tract origin, conceptually similar to a Meckel's diverticulum but without a diverticulum as such. Heterotopic pancreatic tissue occurring alone is more common in the proximal small intestine, duodenum, and stomach than in the ileum, and it is often asymptomatic.

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Meckel’s diverticulum: a cadaveric case report

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20171296 ◽

2017 ◽

Vol 5 (4) ◽

pp. 1715

Author(s):

Shreya Sharma ◽

Preksha Sharma ◽

Sangita Chauhan

Keyword(s):

Small Intestine ◽

Meckel’S Diverticulum ◽

Muscularis Propria ◽

Pancreatic Tissue ◽

Meckel's Diverticulum ◽

Vitelline Duct ◽

Ileocecal Junction ◽

Mesenteric Border ◽

The Common ◽

Heterotopic Tissue

Meckel's diverticulum is the common congenital anamoly of the gastrointentestinal tract, caused due to failure of involution of vitelline duct after seventh or eighth week of intra-uterine life. It is usually present within the last 90cm of terminal ileum. Histologically, Meckel's diverticulum consists of all layers of small intestine. Rarely, heterotopic tissue is present derived from gastric or pancreatic tissue. In the case presented here, Meckel's diverticulum was found on the ante mesenteric border of the ileum with no peritoneal attachment during routine Anatomy cadaveric dissection. It was present 26cm proximal to the ileocecal junction, with no attachment to umbilicus. It’s blood supply was derived from the vitelline artery. Histological examination revealed the presence of 3 layers: mucosa, submucosa and muscularis propria with no heterotopic tissue.

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Small Bowel Obstruction due to Mesodiverticular Band of Meckel's Diverticulum: A Case Report

Case Reports in Medicine ◽

10.1155/2010/901456 ◽

2010 ◽

Vol 2010 ◽

pp. 1-3 ◽

Cited By ~ 5

Author(s):

Aziz Sumer ◽

Ozgur Kemik ◽

Aydemir Olmez ◽

A. Cumhur Dulger ◽

Ismail Hasirci ◽

...

Keyword(s):

Congenital Anomaly ◽

Small Intestine ◽

Case Report ◽

Small Bowel ◽

Intestinal Obstruction ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Rare Complication ◽

Meckel’S Diverticulum ◽

Meckel's Diverticulum

Meckel's diverticulum is the most common congenital anomaly of the small intestine. Common complications related to a Meckel's diverticulum include haemorrhage, intestinal obstruction, and inflammation. Small bowel obstruction due to mesodiverticular band of Meckel's diverticulum is a rare complication. Herein, we report the diagnosis and management of a small bowel obstruction occurring due to mesodiverticular band of a Meckel's diverticulum.

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A Triad of Congenital Diaphragmatic Hernia, Meckel’s Diverticulum, and Heterotopic Pancreas

Case Reports in Pediatrics ◽

10.1155/2014/725945 ◽

2014 ◽

Vol 2014 ◽

pp. 1-3

Author(s):

Parkash Mandhan ◽

Amer Al Saied ◽

Mansour J. Ali

Keyword(s):

Case Report ◽

Congenital Diaphragmatic Hernia ◽

Diaphragmatic Hernia ◽

Chromosomal Abnormalities ◽

Meckel’S Diverticulum ◽

Pancreatic Tissue ◽

Meckel's Diverticulum ◽

Developmental Anomaly ◽

Heterotopic Pancreatic Tissue ◽

First Case

Congenital diaphragmatic hernia is a common developmental anomaly encountered by paediatric surgeons. It is known to be associated with extradiaphragmatic malformations, which include cardiac, renal, genital, and chromosomal abnormalities. Herein, we report a newborn born with concurrent congenital diaphragmatic hernia, Meckel’s diverticulum, and heterotopic pancreatic tissue. This is the first case report of such a triad with description of possible mechanisms of the development.

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Postdiverticular Stasis—Introduction of a New Etiology for Small Intestine Obstruction: A Case Series

Case Reports in Medicine ◽

10.1155/2012/802743 ◽

2012 ◽

Vol 2012 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Seyed Abdollah Mousavi ◽

Hassan Karami

Keyword(s):

Small Intestine ◽

Intestinal Obstruction ◽

Meckel’S Diverticulum ◽

Case Series ◽

Young Age ◽

Meckel's Diverticulum

Introduction. Intestinal obstruction in the setting of Meckel’s diverticulum in young age and with orange and meat bezoar is a rare, previously unreported condition. Since the obstruction point is located immediately after Meckel’s diverticulum in our patients, we attempt to introduce “localized peristalsis insufficiency” as a new etiology for small intestine obstruction while reviewing the findings of previous studies.Conclusion. Intestinal obstruction in the setting of Meckel’s diverticulum and with orange and meat bezoar is a rare, previously unreported condition. Considering the previous reports, we may present the theory oflocalized peristalsis insufficiencyin patients with Meckel’s diverticulum.

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Inverted Meckel’s Diverticulum with Ectopic Pancreatic Tissue as a Source of Severe Gastrointestinal Bleeding

Journal of Gastrointestinal Surgery ◽

10.1007/s11605-009-0838-2 ◽

2009 ◽

Vol 14 (3) ◽

pp. 578-581 ◽

Cited By ~ 15

Author(s):

Marcela Kopáčová ◽

Ladislav Vykouřil ◽

Zdeněk Vacek ◽

Věra Tyčová ◽

Jolana Bártová ◽

...

Keyword(s):

Gastrointestinal Bleeding ◽

Meckel’S Diverticulum ◽

Pancreatic Tissue ◽

Meckel's Diverticulum ◽

Ectopic Pancreatic Tissue ◽

Inverted Meckel’S Diverticulum

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Lipoma within inverted Meckel’s diverticulum as a cause of recurrent partial intestinal obstruction and hemorrhage: A case report and review of literature

World Journal of Gastroenterology ◽

10.3748/wjg.v13.i7.1141 ◽

2007 ◽

Vol 13 (7) ◽

pp. 1141 ◽

Cited By ~ 13

Author(s):

Güldeniz Karadeniz Cakmak

Keyword(s):

Case Report ◽

Intestinal Obstruction ◽

Meckel’S Diverticulum ◽

Meckel's Diverticulum ◽

Review Of Literature ◽

Partial Intestinal Obstruction ◽

Inverted Meckel’S Diverticulum

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Clinicodemographic Profile and Outcome of Patients with Symptomatic Meckel's Diverticulum: Preliminary Findings

Journal of College of Medical Sciences-Nepal ◽

10.3126/jcmsn.v16i1.26769 ◽

2020 ◽

Vol 16 (1) ◽

pp. 37-40

Author(s):

Pravin Joshi ◽

Narayan Belbase ◽

Rohit Kumar Mishra ◽

Mukesh Karki ◽

Lalit Kumar Das

Keyword(s):

Congenital Anomaly ◽

Intestinal Obstruction ◽

Clinical Presentation ◽

Bowel Resection ◽

Wedge Resection ◽

Meckel’S Diverticulum ◽

Meckel's Diverticulum ◽

Fibrous Band ◽

Common Procedure ◽

Segmental Bowel Resection

Background: Meckel's diverticulum is the commonest gastrointestinal congenital anomaly. Though most of the cases do not present clinically, they are challenging to diagnose if become symptomatic. Spectrum of clinical presentation may be different from umbilical fistula, omphalomesenteric cyst to fibrous band from diverticulum to umbilicus. Bleeding, obstruction and infection are the most common complications. Vast majority of them are detected only intra-operatively. Methods: We analyzed our patients who were intra-operatively diagnosed as symptomatic Meckel's Diverticulum. Socio-demographic profile and immediate outcome of operated patients was analyzed from patient's records. Results: Total 9 patients were operated for symptomatic Diverticulitis. All patients were diagnosed intraoperatively. Intestinal obstruction was the commonest presentation. Diverticulectomy was the most common procedure performed followed by wedge resection and segmental bowel resection. Conclusions: Symptomatic Meckel’s Diverticulum is difficult to diagnose pre-operatively. Vast majority of them are found only intra-operatively. Most of the patients do well after resection of Meckel's Diverticulum. Keywords: Meckel’s diverticulum; surgery; symptoms.

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