scholarly journals Meckel’s diverticulum and its plethoric presentation in paediatric surgery: a case series

2021 ◽  
Vol 8 (12) ◽  
pp. 3668
Author(s):  
Gomalaadevee Rajaram ◽  
Pavin Kaur Bal Baldev Singh ◽  
Muhammad Firdaus Bin Madzlan ◽  
John Emmanuel Gilbert Fernandez ◽  
Nurdaliza Binti Mohd Badarudin
Keyword(s):  
Intestinal Obstruction ◽  
Preoperative Diagnosis ◽  
Congenital Abnormality ◽  
Meckel’S Diverticulum ◽  
Case Series ◽  
Meckel's Diverticulum ◽  
Paediatric Surgery ◽  
Female Ratio ◽  
Meckel’S Diverticulitis ◽  
Male To Female

Meckel’s diverticulum (MD) is a congenital abnormality of the gastrointestinal tract resulting from incomplete obliteration of the vitellointestinal duct by 5th to 7th week of gestation. Incidence is 2% in the general population with a 2:1 male to female ratio. The various presentations of MD include gastrointestinal bleeding, intestinal obstruction, diverticulitis and intestinal perforation. Majority of the MD is asymptomatic however the potential risk of developing complication it's about 4-6%. Preoperative diagnosis of MD is challenging. We present 6 cases of MD managed at our centre over the course of 1 year. Two cases presented as intestinal obstruction secondary to mesodiverticular band from MD, one case with bleeding, two cases with intussusception and one case of meckel’s diverticulitis.

scholarly journals Incidence, complications and management of Meckel’s diverticulum

2017 ◽  
Vol 4 (9) ◽  
pp. 3083
Author(s):  
S. K. Pattanaik ◽  
B. P. Dandpat ◽  
J. M. Mishra
Keyword(s):  
Intestinal Obstruction ◽  
Meckel’S Diverticulum ◽  
Postoperative Management ◽  
Meckel's Diverticulum ◽  
Female Ratio ◽  
Mortality And Morbidity ◽  
Operative Removal ◽  
Ectopic Tissue ◽  
Meckel’S Diverticulitis ◽  
Incidental Group

Background: The incidence of complications of Meckel’s diverticulum is decreasing over years. Whether symptomatic or asymptomatic, it is often diagnosed intraoperatively. Controversy exists as regards the method of its operative removal and more so the safety and efficacy of its removal if found incidentally.Methods: A three years prospective and three years retrospective study was undertaken in 125 diverticula found by 3726 laparotomies. Intraoperative findings, type of operation, postoperative management, histopathology and complications in both complicated and asymptomatic diverticula were analyzed.Results: Male to female ratio was 3:2. Found in 3.4% of surgical population, 23 (18.4%) were defined to have complications and 102 were incidental. Complications decreased as the age advanced falling to zero after age 60. Meckel’s diverticulitis, peptic ulcer and umbilical sinus were common in childhood and intestinal obstruction was common in adults. Patients with ectopic mucosa mostly gastric had more complications. 42.2% of incidental cases underwent surgery due to early age, narrow and long diverticula. In both the groups, segmental resection was preferred to simple diverticulectomy. Ectopic tissue could not be substantiated by feeling the induration or thickening of wall. Mortality and morbidity in symptomatic group was 8.7% each and in incidental group 0% and 4.6% respectively.Conclusions: Intestinal obstruction and inflammatory pathology are common complications, gastric mucosa being common association. Narrow and long diverticula in young should be excised prophylactically with zero mortality and acceptable morbidity to prevent further complications.

scholarly journals Acute abdomen in children due to different presentations of complicated Meckel’s diverticulum: a case series

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Hisham A. Almetaher ◽  
Mohammed Awad Mansour
Keyword(s):  
Congenital Abnormality ◽  
Wedge Resection ◽  
Meckel’S Diverticulum ◽  
Case Series ◽  
Postoperative Outcome ◽  
Meckel's Diverticulum ◽  
Gastrointestinal Disorders ◽  
Clinical Presentations ◽  
Life Threatening ◽  
Small Base

Abstract Background Meckel’s diverticulum (MD) is the commonest congenital abnormality of the gastrointestinal tract that occurs in 2% of general population. It remains asymptomatic, but it may lead to life-threatening complications. These complications may be misdiagnosed with other gastrointestinal disorders like acute appendicitis, making its diagnosis challenging among pediatricians and pediatric surgeons. In this study, we reported five cases with different presentations of complicated MD in children. Results Five patients with different presentations of MD were reported during the period from January 2016 to January 2020. Patients’ demographics, clinical presentations, investigations, operative data, and postoperative outcome were recorded and analyzed. Conclusions The present study highlights different presentations of MD. Surgical interference is the main key of treatment of symptomatic MD either by wedge resection of a small base diverticulum or by resection anastomosis of the small intestine in wide base and inflamed diverticulum.

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

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
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.

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 Mimicking T- shaped giant meckel's diverticulum: another rare anatomical variant complicating small bowel obstruction by adhesions

2018 ◽  
Vol 5 (11) ◽  
pp. 3757
Author(s):  
Ambreen Mannan ◽  
Osama A. E. Alshumari
Keyword(s):  
Intestinal Obstruction ◽  
Iliac Fossa ◽  
Meckel’S Diverticulum ◽  
Lower Abdominal Pain ◽  
Tertiary Hospital ◽  
Meckel's Diverticulum ◽  
Bowel Loop ◽  
Anatomical Variant ◽  
Meckel’S Diverticulitis ◽  
Narrow Base

We report case with Meckel's diverticulitis complicated by adhesive intestinal obstruction. An adolescent of 13-yr-old boy with history of recurrent right sided lower abdominal pain and vomiting for two days. According to his mother he had been suffering this type of pain intermittently for last three years which was treated conservatively. This time the pain was out of proportion therefore she reported in tertiary hospital. On examination patient was tender at right iliac fossa region with abdominal guarding. CT scan of abdomen revealed multiple fluid-filled, dilated proximal bowel loops. Meckel's diverticulum was not suspected until diagnostic laparoscopy was performed. Patient was converted to open laparotomy where the giant (13 cm sized), narrow base mimicking T-shaped Meckel’s diverticulum and inter bowel loop adhesions near terminal ileum were seen.  About 20 cm affected ileal segment with Meckel’s diverticulum resected and primary end to end anastomosis performed. The postoperative course remained uneventful. Histopathology report confirms the inflammation of Meckel’s diverticulum. Significance of this type of Meckel’s diverticulum is its T-shaped mimicking appearance with giant size body and narrow base and was manifested with recurrent sub occlusive intestinal obstruction in the period of three years. It is the second ever reported case in English journals.

scholarly journals Symptoms Investigate the Frequency of Various Presentations of the Meckel’s Diverticulum and Help Identify Sign Promptly

2020 ◽  
pp. 1-8
Author(s):  
Ashjaei Bahar ◽  
Ashjaei Bahar ◽  
Amiri Shakiba ◽  
Najdi Fatemeh ◽  
Movahedi Jadid Merisa
Keyword(s):  
Helicobacter Pylori ◽  
Abdominal Pain ◽  
Clinical Symptoms ◽  
Demographic Data ◽  
Meckel’S Diverticulum ◽  
Case Series ◽  
Meckel's Diverticulum ◽  
Helicobacter Pylori Infection ◽  
Female Ratio ◽  
Gastric Type

Background: Meckel's diverticulum is the most common anomaly of the intestine. It is usually asymptomatic but could also be symptomatic with complications such as bleeding, intestinal obstruction, and inflammation. This study was performed to assess the frequency of various presentations of the patients who underwent surgery with the diagnosis of Meckel's diverticulum in Children's Medical Center, Tehran, Iran from March 2005 to March 2011. Material and Methods: Since this study is a case series report (retrospective descriptive study) and the purpose is assessing the various presentation of Meckel’s` diverticulum, we express the frequency and percent frequency of each presentation. The data collection tool was a five-part survey form. The first part was related to demographic data, the second part was related to clinical data, the third part was related to diagnostic data, the fourth part was related to treatment data and the fifth part was related to histological data. Data were analysed using SPSS statistical program. Result: We found 49 patients in this period (71% male 29% female). The mean age was 3.5 years (1 month to 9 years). The male to female ratio was 2.5. The most common clinical symptoms were abdominal pain (63%). forty-three percent of patients had single symptoms and the others had combined symptoms such as abdominal pain and hematochezia. Only 8 patients with lower gastrointestinal bleeding had a Technetium scan and all of them were positive. Associated findings during surgery included appendicitis and invagination. Our sonographic imaging findings were nonspecific. In the pathologic report, 6 patients had gangrene in specimens and 2 perforations. The lining was of gastric type in 24 specimens pancreatic in 3 and mixed in 2 specimens. None of those with the gastric type of mucosa showed Helicobacter pylori infection. Conclusion: Regarding our findings, clinical findings of Meckel's diverticulum in our study were rather the same as in the literature. Pathologic examination of specimens revealed that most diverticula were lined by gastric type of mucosa. None of those with the gastric type of mucosa showed Helicobacter pylori infection.

THE UMBILICAL POLYP, A REMNANT OF THE OMPHALOMESENTERIC DUCT

PEDIATRICS ◽  
1957 ◽  
Vol 20 (1) ◽  
pp. 98-100
Author(s):  
Stanley E. Crawford
Keyword(s):  
Young Children ◽  
Intestinal Obstruction ◽  
Neonatal Period ◽  
Meckel’S Diverticulum ◽  
Meckel's Diverticulum ◽  
Recent Case ◽  
Early Age ◽  
Review Of The Literature ◽  
Omphalomesenteric Duct ◽  
Umbilical Polyp

THE PURPOSE of this paper is to report a recent case of an umbilical polyp and intestinal obstruction during the neonatal period. Umbilical polyps are rare. When present, they may be associated with Meckel's diverticulum because both are remnants of the omphalomesenteric duct. The presence of the visible polyp may give an external clue to otherwise obscure intraabdominal symptoms. A review of the literature earlier than 1916 is well summarized in a book by Thomas Cullen. This unusual volume lists six cases of umbilical polyp accompanied by other pathologic complications of Meckel's diverticulum. This author stressed that in these cases it should be pointed out to either the patient or his parents that possible intra-abdominal duct remnants may, at any time, give rise to symptoms such as intestinal obstruction. Penberthy and Benson reported a 9-year-old male with an umbilical polyp which had been present since birth and was without discharge. This youngster died following operation for intestinal obstruction due to volvulus about the diverticulum and its fibrous connection with the umbilical polyp. These authors pleaded for early elective operations in these cases prior to such complications. Gross gave other reasons for observation, and exploration at a reasonably early age, if a Meckel's diverticulum is suspected. Peritonitis from a ruptured Meckel's diverticulum is peculiarly dangerous; in young children the protecting omentum is inadequate and the migrating nature of the anomaly adds to the danger. Fluid from perforation of a diverticulum is usually of greater volume than that found in appendiceal rupture and abscess.

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