S2987 A Rare Cause of Abdominal Pain in an Adult: Meckel’s Diverticulitis

A 30-year-old male presented to the emergency room with complaints of periumbilical abdominal pain and vomiting. A contrast-enhanced computed tomography scan of the abdomen revealed subacute intestinal obstruction with dilated small bowel loops and associated bowel wall thickening of mid and distal ileal bowel loops. There was a fairly large small bowel diverticulum arising from the antimesenteric border of distal ileum. Findings were suggestive of small bowel diverticulitis or possibly focal enteritis. The patient was then immediately taken to the operating room for emergency laparotomy and was intra-operatively found to have a thickened Meckel’s diverticulitis with adjacent small bowel obstruction. Meckel’s diverticulectomy was performed in continuity with the adjacent inflamed small bowel. The patient had a stable post-operative course without any complications and was discharged within a week.

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

International Surgery Journal ◽

10.18203/2349-2902.isj20212288 ◽

2021 ◽

Vol 8 (6) ◽

pp. 1904

Author(s):

Aishwarya Emerald Manohar ◽

M. S. Kalyan Kumar ◽

V. Vijayalakshmi ◽

R. Kannan

Keyword(s):

Abdominal Pain ◽

Small Bowel ◽

Intestinal Obstruction ◽

Meckel’S Diverticulum ◽

Postoperative Recovery ◽

Meckel's Diverticulum ◽

Intestinal Malrotation ◽

Emergency Laparotomy ◽

Meckel’S Diverticulitis ◽

Subacute Intestinal Obstruction

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.

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A Rare Cause of Abdominal Pain in Adults: Meckel’s Diverticulitis

Case Reports in Gastroenterology ◽

10.1159/000494752 ◽

2018 ◽

Vol 12 (3) ◽

pp. 709-714 ◽

Cited By ~ 3

Author(s):

Usman Pirzada ◽

Hassan Tariq ◽

Sara Azam ◽

Kishore Kumar ◽

Anil Dev

Keyword(s):

Abdominal Pain ◽

Small Bowel ◽

Meckel’S Diverticulum ◽

Meckel's Diverticulum ◽

Emergency Laparotomy ◽

Contrast Enhanced ◽

Meckel’S Diverticulitis ◽

The Right ◽

Enhanced Computed Tomography

A 42-year-old man presented to the emergency room with complaints of periumbilical abdominal pain. A contrast-enhanced computed tomography revealed mucosal thickening in the small bowel of the right abdomen. There was a fairly large small bowel diverticulum associated with this segment. Findings were suggestive of small bowel diverticulitis or possibly focal enteritis. A Meckel’s diverticulum scan was diagnostic of Meckel’s diverticulum. The patient was then immediately taken to the operating room for emergency laparotomy and was intra-operatively found to have a thickened Meckel’s diverticulitis with adjacent small bowel obstruction. Meckel’s diverticulectomy was performed in continuity with the adjacent inflamed small bowel. The patient had a stable postoperative course without any complications and was discharged within 10 days. At the 3-month follow-up, the patient was well and remained asymptomatic.

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Meckel's Diverticulitis Presenting with Abdominal Pain and Angina

Radiology Case Reports ◽

10.2484/rcr.v3i3.166 ◽

2008 ◽

Vol 3 (3) ◽

pp. 166

Author(s):

Roberto Andres Novoa ◽

Kitt Shaffer

Keyword(s):

Abdominal Pain ◽

Meckel’S Diverticulitis

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Meckel's diverticulitis: a rare cause of abdominal pain during pregnancy

ANZ Journal of Surgery ◽

10.1111/ans.13516 ◽

2016 ◽

Vol 88 (7-8) ◽

pp. 800-802

Author(s):

Jacob Eisdorfer ◽

Noah T. Zinkin ◽

David E. Rivadeneira

Keyword(s):

Abdominal Pain ◽

Meckel’S Diverticulitis

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It is not Appendicitis! It is Appendicitis Epiploica, the Great Pretender

Journal of Surgical Sciences ◽

10.3329/jss.v23i2.46119 ◽

2020 ◽

Vol 23 (2) ◽

pp. 95-97

Author(s):

Farah Nobi ◽

Shayda Ali ◽

Md Mostafizur Rahman ◽

Russel Ahmed Khan Lodi ◽

Mohammad Arman Zahed Basunia ◽

...

Keyword(s):

Abdominal Pain ◽

Elevated Temperature ◽

Blood Cell ◽

Cell Count ◽

Blood Cell Count ◽

Spontaneous Thrombosis ◽

Rebound Tenderness ◽

Meckel’S Diverticulitis ◽

Appendices Epiploicae ◽

Specific Symptoms

Appendicitis epiploica or epiploicae appendagitis, an uncommon cause of abdominal pain, is usually per-operatively diagnosed. The pedunculated fat-filled small pouches or appendices epiploicae on the serosal surface of the colon often become twisted and sometimes spontaneous thrombosis occurs. Such events lead to ischemia and inflammation at the base of the fatty lobes i.e., Appendicitis epiploicae. Symptoms include sharp localized pain in either iliac fossae and in some cases there is elevated temperature and white blood cell count. In a quarter of the patients there is rebound tenderness and very rarely nausea and vomiting, diarrhoea or constipation. This condition is more common among middle aged males and given its non-specific symptoms. It is usually confused with other more common conditions such as Meckel’s diverticulitis and appendicitis. Less than 8% of patients suspected of having appendicitis or diverticulitis are found to actually have appendicitis epiploicae. Here we report two extremely rare cases of appendicitis epiploica in Bangladesh. Journal of Surgical Sciences (2019) Vol. 23(2): 95-97

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IN A MECKEL’S DIVERTICULUM, PEPTIC PERFORATION - A CLASSIC SNAPSHOT! PERFORACIÓN PÉPTICA EN UN DIVERTICULO DE MECKEL: ¡UNA INSTANTÁNEA TÍPICA!

Revista Argentina de Anatomía Clínica ◽

10.31051/1852.8023.v2.n3.13894 ◽

2016 ◽

Vol 2 (3) ◽

pp. 119-123

Author(s):

Sujatha N Moorthy ◽

Rekha Arcot

Keyword(s):

Abdominal Pain ◽

Case Report ◽

Meckel’S Diverticulum ◽

Adult Life ◽

Meckel's Diverticulum ◽

Emergency Laparotomy ◽

Anatomical Anomaly ◽

Paediatric Age ◽

Meckel’S Diverticulitis ◽

Multiorgan Dysfunction Syndrome

El divertículo de Meckel es un remanente congénito localizado en el ileum distal, el cual resulta de un defecto en el cierre del saco de Yolk. Esta anomalía es comunmente detectada en la poblacion pediátrica antes de los 2 años de edad. Por lo tanto, es una causa extraña de obstrucción intestinal y de mortalidad en adultos. Este es el reporte de un individuo de 26 años con 3 dias de fiebre y seis dias de dolor abdominal y vómito continuo. La laparotomía exploratoria demostró la presencia de una diverticulitis de Merkel y signos de obstrucción intestinal. Se realizó la resección del divertículo y parte del ileum afectado, seguido por anastomosis ileo-ileal. Sin embargo, el curso clinico del paciente se deterioró rápidamente debido al desarrollo de falla renal aguda y multiorgánica. Estas complicaciones llevaron al fallecimiento del paciente en su cuarto dia postoperatorio. En conclusión, la baja frecuencia de esta anomalía en adultos dificulta su diagnostico oportuno, teniendo como consecuencia un aumento en la mortalidad de estos casos clínicos. Meckel’s diverticulum is a congenital outpouching located in the distal ileum which occurs due to the failure of obliteration of the yolk stalk. The peak age in which this anomaly is mostly found is the paediatric age especially below the age of 2. Hence it is noted as an uncommon cause of intestinal obstruction and fatality in adult life. This is a case report of a 26 year old man with abdominal pain and vomiting for 6 days associated with fever for 3 days. Emergency laparotomy revealed Meckel’s diverticulitis with small bowel obstruction. Meckel’s diverculectomy with ileal resection and ileoileal anastamosis was performed. However, the patient developed renal dysfunction leading to Multiorgan Dysfunction Syndrome and died on the 4th post operative day. This anatomical anomaly is rare in adult patients and is difficult to diagnose early due to its bizarre presentation resulting in high mortality. Hence we find this case of interest.

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The Diagnostic Value of C-Reactive Protein and Total Leukocyte Count in Patients with Acute Abdominal Pain In Children.

Albanian Journal of Trauma and Emergency Surgery ◽

10.32391/ajtes.v2i2.9 ◽

2018 ◽

Vol 2 (2) ◽

Author(s):

Ferizate Dika Haxhirexha ◽

Agron Dogjani ◽

Ledia Kaçi ◽

Lutfi Zylbeari ◽

Kastriot Haxhirexha

Keyword(s):

Abdominal Pain ◽

Acute Abdominal Pain ◽

Acute Phase Proteins ◽

Diagnostic Value ◽

Total Leukocyte Count ◽

C Reactive Protein ◽

Surgical Department ◽

Reactive Protein ◽

Inflammatory Conditions ◽

Meckel’S Diverticulitis

Background: C-reactive protein (CRP) is one of the acute-phase proteins which increases during inflammatory conditions. Nowadays, C-reactive protein (CRP) is a commonly used biomarker especially in emergency department (ED) for diagnostics of febrile and infectious patients. It is almost impossible to distinguish the bacterial from nonbacterial (viral) infection by CRP level only - so the detailed history of onset of disease is very important to establish the diagnosis of bacterial infection as a cause of acute abdominal pain.Objective: The aim of this study was to establish the diagnostic value of leucocyte and CRP count in in diagnosing acute abdominal pain.Material and methods: We retrospectively evaluated 159 patients with acute abdominal pain admitted to the surgical department of the Clinical Hospital of Tetova and PHO “Alba – Med” over a period of 2 yearsrespectively from January 20016 to January 2018. All patients included in this study was aged between five to 15 years old.Results: During the study period there were 158 patients (96 were females and 56 males). All the patients suffered from acute abdominal pain, whereas 45 of them had a surgical condition, respectively in 42 of them acute appendicitis as a cause of pain, Meckel’s diverticulitis, jejunal intussusception and ruptured ovarian cyst in three other patients. In 105 patients nonsurgical condition was the reason of acute abdominal pain. CRP was performed within 24 h after admission in all the patients. In the group of patients with surgical disease in 41 of them (91 %) the value of CRP was more than > 5g/L.Conclusions: According to our experience we conclude that the CRP level is not sufficient to predict patients with acute abdominal pain that require surgical treatment.

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The Mechanism of Abdominal Pain

Gastroenterology ◽

10.1016/s0016-5085(49)80140-5 ◽

1949 ◽

Vol 12 (3) ◽

pp. 523

Keyword(s):

Abdominal Pain

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