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

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.

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

2018 ◽  
Vol 12 (3) ◽  
pp. 709-714 ◽  
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.

scholarly journals “Meckel’s Diverticulum” – A diagnostic bizarre of abdominal pain in adults

2020 ◽  
Vol 2 ◽  
pp. 58-60
Author(s):  
Vipin Kumar Bakshi ◽  
Manjot Kaur ◽  
Gajendra Bhatti
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Wall Thickening ◽  
Emergency Laparotomy ◽  
Contrast Enhanced ◽  
Antimesenteric Border ◽  
Meckel’S Diverticulitis ◽  
Bowel Wall Thickening ◽  
Subacute Intestinal Obstruction ◽  
Enhanced Computed Tomography

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.

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

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.

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 Congenital Vitelline Band Causing Intestinal Obstruction in an Adult with a Double Inferior Vena Cava

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Mihiri Wettasinghe ◽  
Kumari Pussepitiya ◽  
Bandula Samarasinghe ◽  
Nuwan Wickramasinghe
Keyword(s):  
Small Bowel ◽  
Inferior Vena Cava ◽  
Intestinal Obstruction ◽  
Bowel Obstruction ◽  
Inferior Vena ◽  
Meckel’S Diverticulum ◽  
Vena Cava ◽  
Iliac Vein ◽  
Meckel's Diverticulum ◽  
Double Inferior Vena Cava

Introduction. Vitelline artery remnants are rare causes of intra-abdominal bands leading to bowel obstruction. These bands may be associated with Meckel’s diverticulum. Double inferior vena cava (IVC) is a rare presentation and is usually identified incidentally. Case Presentation. A sixty-year-old male presented with progressive vomiting for five days and he was clinically diagnosed with intestinal obstruction. Plain X-ray abdomen showed evidence of small bowel obstruction. CT scan of the abdomen revealed dilated small bowel loops with a small outpouching in the distal ileum with a band like structure attached to it. In the CT, left sided patent IVC draining into the left renal vein was identified. Left external iliac vein was in continuity with the left IVC. Left internal iliac vein was draining into the right IVC. Exploratory laparotomy revealed a Meckel’s diverticulum with a band identified as the vitelline remnant attached to its apex and inserting at the anterior abdominal wall near the umbilicus. Discussion. Meckel’s diverticulum with vitelline bands, although rare, should be borne in mind in adult patients with intestinal obstruction. Identification of this anomaly can be difficult in imaging studies. Presence of double IVC should be mentioned in the imaging findings to prevent possible catastrophic complications during surgery.

scholarly journals T-shaped Meckel’s diverticulum: a rare anatomical variant complicating small bowel volvulus

2018 ◽  
Vol 5 (8) ◽  
pp. 2929
Author(s):  
Vergis Paul ◽  
Ramu R. ◽  
Kocheril Sheryl Mathews ◽  
Ashly Thomas ◽  
Reesha P. A. ◽  
...  
Keyword(s):  
Small Bowel ◽  
Intestinal Obstruction ◽  
Terminal Ileum ◽  
Meckel’S Diverticulum ◽  
Exploratory Laparotomy ◽  
Meckel's Diverticulum ◽  
Anatomical Variant ◽  
Small Bowel Volvulus ◽  
Common Presentation ◽  
Congenital Diverticulum

The Meckel's diverticulum is a congenital diverticulum arising from the terminal ileum and is the unobliterated proximal portion of the vitellointestinal duct. Intestinal obstruction due to Meckel’s diverticulum is the most common presentation in adults and is the second most common presentation in children. We present a case of a 58-year-old gentleman presented with acute abdomen who was later found to have Giant T- shaped Meckel’s Diverticulum complicating small bowel volvulus on exploratory laparotomy. A T-shaped Meckel's diverticulum has not yet been described.

scholarly journals Diverse Presentation of Meckel’s Diverticulum in Pediatric Patients

2018 ◽  
Vol 14 (3) ◽  
pp. 161-164
Author(s):  
Sujit Kumar ◽  
Aditya Jalan ◽  
Bhupendranath Patowary ◽  
Sarita Rana Gurung ◽  
Narayan Belbase ◽  
...  
Keyword(s):  
Intestinal Obstruction ◽  
Average Distance ◽  
Demographic Data ◽  
Meckel’S Diverticulum ◽  
Histological Finding ◽  
Massive Bleeding ◽  
Meckel's Diverticulum ◽  
Emergency Laparotomy ◽  
Superficial Wound ◽  
Intestine Mucosa

IntroductionMeckel’s Diverticulum is the most common congenital disease and seen in 2% of population. It is difficult to diagnose preoperative, mostly seen during operation with its various presentation.Material and Methods This is a retrospective study in which all the cases diagnosed as Meckel’s diverticulum with its complication diagnosed while doing operation were included. Demographic data, clinical presentation, preoperative diagnosis, intraoperative findings, surgical procedure performed, histopathological report and postoperative follow up of patients were recorded and statistically analyzed. The aim of this study was to assess various presentation of Meckel’s diverticulum in 8 years of duration in college of medical sciences, Bharatpur Nepal. ResultsOut of 32 cases, there were 20 male and 12 female with M:F ratio1.66:1. The mean age was 8.34 ± 3.98 years. All together sixteen (50%) patients had features intestinal obstruction. Perforation was seen in 28.1% patients, intussusception in 21.8%, diverticulitis in 15.6%, small bowel volvulus around fibrous band in 18.8%, internal herniation in 9.4% and massive bleeding in 6.3% patients. The average distance from ileocecal junction was 40-60 cm. All cases underwent emergency laparotomy, presence of Meckel’s diverticulum was incidental intraoperative finding. Three cases had superficial wound infection. Small intestine mucosa followed by gastric, pancreatic and colonic mucosa were most common histological finding. The average duration of hospital stay was 5 to 8 days.ConclusionMeckel's Diverticulum is a true diverticular anomaly that may remain clinically silent for lifetime, or it may have life-threatening complications. Due to nonspecific features in case of acute abdomen, Meckel’s diverticulum and its complications should be kept as an important differential diagnosis.Keywords: intestinal obstruction; meckel’s diverticulum; volvulus. 

scholarly journals Gastrointestinal stromal tumor in perforated Meckel’s diverticulum: a case report and literature review

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Naoki Hashizume ◽  
Saki Sakamoto ◽  
Suguru Fukahori ◽  
Shinji Ishii ◽  
Nobuyuki Saikusa ◽  
...  
Keyword(s):  
Small Bowel ◽  
Gastrointestinal Stromal Tumor ◽  
Meckel’S Diverticulum ◽  
Ileocecal Valve ◽  
Meckel's Diverticulum ◽  
Stromal Tumor ◽  
Free Air ◽  
Meckel’S Diverticulitis ◽  
Colon And Rectum ◽  
Enhanced Computed Tomography

Abstract Introduction Gastrointestinal stromal tumor (GIST) is rare neoplasms of the gastrointestinal tract associated with high rates of malignant transformation. GIST has been found largely in the stomach, small bowel, colon and rectum, and esophagus, but about 5% are found in other locations. We herein report a 56-year-old woman with a GIST in perforated Meckel's diverticulum. After encountering this patient, a review of the literature found reports of 18 similar patients. Case presentation A 56-year-old woman diagnosed with galactosialidosis (β-galactosidase-neuraminidase deficiency) presented with vomiting. On contrast-enhanced computed tomography, peritonitis due to perforation of the intestine was diagnosed based on the free air and dilated loop of the small bowel. Laparotomy revealed perforation of Meckel’s diverticulitis located 50 cm from the ileocecal valve. Partial resection of the ileum, including the diverticulum, and end-to-end anastomosis of the small intestine were performed. Regarding the pathological findings, the edge of the diverticulum wall consisted of a solid mass measuring 1.0 cm in size, and the tumor cells were spindle-shaped with 1 mitosis present per 50 high-power fields. The diagnosis was established as GIST of the Meckel's diverticulum. The postoperative period was uneventful. Follow-up at two years revealed no evidence of recurrence. Conclusion GIST in perforated Meckel's diverticulum is very rare. The potential for the coexistence of GIST or other tumor should be considered in the treatment of perforated Meckel's diverticulum.

scholarly journals Perforated Meckel’s Diverticulum Lithiasis: An Unusual Cause of Peritonitis

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Umasankar Mathuram Thiyagarajan ◽  
Amirthavarshini Ponnuswamy ◽  
Atul Bagul ◽  
Prabakar Ponnuswamy
Keyword(s):  
Gastrointestinal Tract ◽  
Small Bowel ◽  
Intestinal Obstruction ◽  
Acute Abdomen ◽  
Congenital Malformation ◽  
Healthy Individual ◽  
Stone Formation ◽  
Meckel’S Diverticulum ◽  
Exploratory Laparotomy ◽  
Meckel's Diverticulum

Meckel’s diverticulum is the commonest congenital malformation of gastrointestinal tract and represents a persistent remnant of the omphalomesenteric duct. Although it mostly remains silent, it can present as bleeding, perforation, intestinal obstruction, intussusception, and tumours. These complications, especially bleeding, tend to be more common in the paediatric group and intestinal obstruction in adults. Stone formation (lithiasis) in Meckel’s diverticulum is rare. We report a case of Meckel’s diverticulum lithiasis which presented as an acute abdomen in an otherwise healthy individual. The patient underwent an exploratory laparotomy which revealed a perforated Meckel’s diverticulum with lithiasis; a segmental resection with end-to-end anastomosis of small bowel was performed. Patient recovery was delayed due to pneumonia, discharged on day 20 with no further complications at 6 months following surgery.

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