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.

scholarly journals Unusual Presentation of Meckel’s Diverticulum: Gangrene due to Axial Torsion

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Ahmet Rencuzogullari ◽  
Kubilay Dalci ◽  
Orcun Yalav
Keyword(s):  
Congenital Anomaly ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Preoperative Diagnosis ◽  
Iliac Fossa ◽  
Meckel’S Diverticulum ◽  
Meckel's Diverticulum ◽  
Life Threatening ◽  
Operative Findings ◽  
The Right

Meckel’s diverticulum is the most common congenital anomaly of the small bowel. The majority of cases are asymptomatic; however, life-threatening complications can also take place. We present a case of a 37-year-old male who was admitted with symptoms of acute, severe abdominal pain in the right iliac fossa. The patient was operated on with the preoperative diagnosis of acute appendicitis but the operative findings were consistent with torted Meckel’s diverticulum due to presence of mesodiverticular band and he was treated successfully with surgical resection.

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 A Rare Case of Acquired Transthoracic Littre's Hernia

2019 ◽  
Vol 05 (04) ◽  
pp. e150-e153
Author(s):  
Arthur Curmi ◽  
Anthony P. Dimech ◽  
Rebecca Dalli ◽  
Ayman Mostafa ◽  
Joseph Debono
Keyword(s):  
Motor Vehicle ◽  
Meckel’S Diverticulum ◽  
Lower Abdominal Pain ◽  
Rib Fractures ◽  
Meckel's Diverticulum ◽  
First Case ◽  
History Of ◽  
Littre’S Hernia ◽  
The Right ◽  
Littre Hernia

Abstract Introduction The Littre hernia is a rare complication of Meckel's diverticulum. Meckel's diverticulum is vestigial remnant of the omphalomesenteric duct occurring in approximately 2% of the general population with an estimated 4 to 16% risk of complications. Usual sites of the Littre hernia include inguinal (50%), umbilical (20%), and femoral (20%). We report a case of an acquired transthoracic Littre's hernia occurring through the left part of the diaphragm triggered by a history of traumatic rib fractures associated with alcohol abuse. Case Report A 71-year-old man presented with 4-day history of worsening shortness of breath, colicky lower abdominal pain, and inability to open bowels despite passing flatus, without nausea or vomiting. His past medical history was remarkable for multiple traumatic rib fractures caused by falls which were associated with excessive alcohol consumption. A noncontrast computed tomography (CT) scan of the abdomen and pelvis showed distended jejunal loops containing air/fluid levels likely resulting from herniated jejunum between the left chest wall and left diaphragm. An urgent laparotomy was performed which revealed small bowel and omentum herniating through a small defect in the left posterior hemidiaphragm. The contents of the sac were reduced and a Meckel's diverticulum was found inside the sac, characteristic of Littre's hernia. The diaphragmatic defect was closed and the Meckel diverticulum stapled and excised. Discussion Herniation of Meckel's diverticulum through the diaphragm most commonly occurs in the pediatric population. Acquired transthoracic Littre's hernia is rare and may arise following thoracobdominal trauma caused by surgery, motor vehicle accidents, and falls from height. Left-diaphragmatic tears are characteristically more clinically apparent and symptomatic than the right since the liver often has a protective effect on the right part of the diaphragm. Herniation of abdominal contents in the chest cavity causes respiratory distress and requires urgent surgical correction. Diagnosis is often delayed since diaphragmatic hernia tends to present very late after the initial trauma, subjecting the patient to possible life-threatening complications. While it is easier to reduce the herniated contents and repair the diaphragm via a thoracic approach, laparotomy is often preferred in cases of acute trauma associated with intra-abdominal injuries. Repair of Littre's hernia then consists of resection of the diverticulum and herniorraphy. Conclusion Internal Littre's hernia is usually of congenital origin. This is the first case of a transthoracic Littre's hernia caused by traumatic rib fractures. Hence, it is of utter importance that a clinician is aware of such uncommon pathology.

scholarly journals Perforated Meckel’s Diverticulum with Pancreatic and Gastric Heterotropia and Acute Peritonitis - A Case Report

2022 ◽  
Vol 12 (2) ◽  
pp. 115-118
Author(s):  
Monika Mehjabin ◽  
Mohammed Kamal ◽  
Md Abdus Sabur Talukder ◽  
Mizanur Rahman ◽  
Md Mozzamel Hoque ◽  
...  
Keyword(s):  
Histopathological Examination ◽  
Wedge Resection ◽  
Iliac Fossa ◽  
Meckel’S Diverticulum ◽  
Acute Onset ◽  
Meckel's Diverticulum ◽  
Midline Incision ◽  
Acute Peritonitis ◽  
First Case ◽  
Meckel’S Diverticulitis

Meckel’s diverticulum, the most common congenital anomaly of small bowel although usually silent, can cause complications like intestinal obstruction, bleeding, diverticulitis, perforation etc. We report a case, which presented with acute onset of severe pain in right iliac fossa which was clinically and sonographically diagnosed as acute appendicitis. Histopathological report of appendix was non specific findings. Four days after appendectomy patient again came with features of acute abdomen. X-ray abdomen showed free gas under diaphragm. Abdomen was explored with a midline incision, a perforated Meckel’sdiverticulum was found which was managed by wedge resection and repair of the ileum. Histopathological examination of specimen revealed diverticular wall with normal appearing intestinal mucosa and muscle coat which showed two heterotrophic tissues (pancreatic and gastric ) in the wall.These also showed features of perforation and acute peritonitis. This is probably the first case of Meckel’s diverticulitis with heterotropic pancreatic and gastric tissue in Bangladesh. J Shaheed Suhrawardy Med Coll 2020; 12(2): 115-118

Subacute Meckel’s diverticulum perforation

2021 ◽  
Vol 14 (3) ◽  
pp. e237840
Author(s):  
Alberto Robles Méndez Hernández ◽  
Oscar Alejandro Mora-Torres ◽  
Hugolino Andrade Lopez ◽  
Jorge Alfonso Perez Castro Y Vazquez
Keyword(s):  
Abdominal Pain ◽  
Adult Population ◽  
Meckel’S Diverticulum ◽  
Ileocecal Valve ◽  
The Elderly ◽  
Meckel's Diverticulum ◽  
Intestinal Bleeding ◽  
History Of ◽  
Mechanical Anastomosis

Meckel’s diverticulum is the most common intestinal congenital defect, its prevalence is 0.2%–4.0% and it occurs more commonly in children younger than 2-year old with intestinal bleeding and abdominal pain. Perforation in the elderly is very rare with no more than 35 articles reported worldwide. Here we report the case of a 62-year-old man who was admitted to hospital with a history of acute abdominal pain with a 20-day onset. The patient was treated with laparotomy and 30 cm ileal resection was performed for an 8×5 cm perforated ileum tumour at 50 from ileocecal valve with a side-to-side mechanical anastomosis for reconstruction. Having morbidity Clavien-Dindo scale I in postsurgical and good outcome in 6-month follow-up. Meckel’s diverticulum is an infrequent pathology in paediatric and even rarer in adult population, however, it is always important to keep in mind how to act when is seen either as a finding or as a complication.

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.

SPONTANEOUS PERFORATION OF MECKEL'S DIVERTICULUM: A CASE REPORT AND REVIEW OF LITERATURE

2021 ◽  
pp. 50-51
Author(s):  
B. Santhi ◽  
Subhashini . A ◽  
Preethi. V
Keyword(s):  
Case Report ◽  
Unusual Case ◽  
Iliac Fossa ◽  
Meckel’S Diverticulum ◽  
Meckel's Diverticulum ◽  
Uneventful Recovery ◽  
Emergency Laparotomy ◽  
High Grade Fever ◽  
Meckels Diverticulum ◽  
The Right

Meckel's diverticulum is the commonest congenital abnormality of the gastrointestinal tract. Hemorrhage obstruction and inammation are the three main categories of complications resulting from Meckel's diverticulum. Spontaneously perforation of Meckel's diverticulum is very rare and mimics acute appendicitis. We report a case of 65 year-old female, who presented since 2 days worsening abdominal pain predominantly in the right iliac fossa associated with high grade fever and nausea. On physical examination her abdomen revealed diffuse tenderness, more over the right iliac fossa and the hypogastric region with guarding in the right iliac fossa. A provisional diagnosis of appendicular perforation was made. Our patient had an emergency laparotomy, where a perforated Meckel's diverticulum and advanced peritonitis were discovered. A resection of ileum with meckels diverticulum with end to end anastomosis of ileal loops were performed. Heterotopic mucosa of diverticulitis was conrmed on histopathology. The patient made an uneventful recovery postoperatively . This case report is an interesting and unusual case of Meckel's diverticulum complications and highlights the importance of considering Meckel's diverticulum as a differential diagnosis in every patient presenting with acute abdomen.

scholarly journals Phytobezoar Within Meckel’s Diverticulum Presenting With Partial Intestinal Obstruction

2020 ◽  
Author(s):  
Reza Mosaddegh ◽  
Mohammad Hossein Ghafouri ◽  
Mahdi Rezai ◽  
Mohammad Reza Maghsoudi ◽  
Farzaneh Beigmohammadi
Keyword(s):  
Gastrointestinal Tract ◽  
Intestinal Obstruction ◽  
Case Reports ◽  
Meckel’S Diverticulum ◽  
Ileocecal Valve ◽  
Meckel's Diverticulum ◽  
Midline Laparotomy ◽  
Ectopic Tissue ◽  
History Of ◽  
Partial Intestinal Obstruction

Introduction: Meckel’s Diverticulum (MD) affects approximately 2% of the population. Phytobezoar is defined as a vegetable and fiber-based ball in the gastrointestinal tract. We report a rare case of phytobezoar within MD presenting with partial intestinal obstruction. Case Reports: We hereby present a 20-year-old man who referred to the Emergency Department of a hospital with a two-day history of nausea, vomiting, abdominal pain, and constipation. He underwent a midline laparotomy with surgical exploration, which revealed an MD 60 cm proximal to ileocecal valve containing phytobezoar. Histopathology reported the extracted specimen as an MD without ectopic tissue. Conclusion: Meckel’s diverticulum can be affected by bezoars as well as other parts of the gastrointestinal tract. We recommend that phytobezoar within MD be considered among differential diagnosis of bowel obstruction.

scholarly journals Acute Right Lower Abdomen in a Patient with a History of Gastrointestinal Stromal Tumor

2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
Author(s):  
Dabanjan Bandyopadhyay ◽  
Hugo J. R. Bonatti
Keyword(s):  
Gastrointestinal Stromal Tumor ◽  
Meckel’S Diverticulum ◽  
Treatment Options ◽  
Open Appendectomy ◽  
Acute Onset ◽  
Minimal Invasive ◽  
Meckel's Diverticulum ◽  
Stromal Tumor ◽  
Rare Presentation ◽  
History Of

Background. Gastrointestinal stromal tumor (GIST) is an uncommon tumor of the GI tract usually seen in elderly patients, often difficult to diagnose because of the unspecific symptoms such as abdominal pain and fullness. Recurrent GIST may have an even more obscure clinical presentation. Case Report. A 44-year-old female with a history of surgically treated GIST presented to the emergency room complaining of acute onset sharp RLQ pain, nausea, and vomiting. Clinically, she had RLQ tenderness with rebound, her WBC was elevated, and CT scan showed signs of appendicitis and also soft tissue masses suspicious for malignancy. After contemplating treatment options including antibiotics and further workup, it was recommended to proceed with surgery. Laparoscopy showed a thickened appendix with nodular infiltration and multiple mass-like lesions in the RLQ not amendable to minimal invasive resection. From a lower midline incision, an open appendectomy and excision of multiple masses in the terminal ileum and in the abdominal wall were done. Narrow-based Meckel’s diverticulum with multiple nodular lesions was also removed. Pathology identified appendicitis and serosal involvement of GIST in all specimens staining positive for CD68, CD117, and vimentin. The patient was started on imatinib and remained recurrence-free after 6 months. Conclusions. This case illustrates a rare presentation of acute symptomatic recurrent metastatic GIST. Our patient was unusually young, and GIST recurrence presented with acute RLQ pain suggestive for acute appendicitis and also involved Meckel’s diverticulum. Surgical debulking followed by imatinib seems to be a reasonable approach in such cases.

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