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Historical background The first description of a diverticulum of the small intestine is attributed to Fabricius Hildanus in 1598. In 1742, a small bowel diverticulum strangulated in an inguinal hernia was reported by Littre. In 1809, the German comparative anatomist Johann Friedrich Meckel the Younger first published his observations on anatomy and embryology of the diverticulum that bears his name. In 1898, Kuttner reported small bowel intussusception secondary to an invaginated Meckel’s diverticulum (MD). Ectopic gastric mucosa and inflammation in an MD were first described by Salzer in 1907 and Gramen in 1915, respectively.

The majority of duodenal diverticula are asymptomatic but may also induce major haemorrhage on rare occasions. Gastrointestinal bleeding due to angiodysplasia in a duodenal diverticulum is very rare. We present a 70-year-old woman with repeated melaena in whom the diagnosis of angiodysplasia in a diverticulum of the fourth part of the duodenum could be made by standard upper endoscopy.

A 10-month-old boy had rectal bleeding. A Meckel's diverticulum radionuclide scan showed a peculiar pattern. At surgery, an intestinal duplication with cystic dilatation and perforation were found. Awareness of this pattern is important when interpreting Meckel's diverticulum scans.

Complications related to Meckel’s diverticulum are not unusual. However, involvement of the urinary tract is extremely rare. To our knowledge this is the first reported case of ureteral obstruction due to perforation of Meckel’s diverticulum.

Two patients with giant colonic diverticula were operated upon within one week. Uncommon features of this rare condition were observed in both patients: 1) the diverticulum was located outside the sigmoid colon, 2) smooth-muscle fibers and ganglion cells were present in the wall of the diverticulum, and 3) free perforation into the peritoneal cavity was the presenting symptom. Barium enema in one patient showed no communication between the diverticulum and the colonic lumen, despite evidence of such communication on histologic examination. Both patients were successfully treated by simple excision of the diverticulum without colonic resection.

The management of two patients with benign duodenocolic fistula is reported. In both patients, laparotomy clearly demonstrated the origin of a fistulous tract arising from a duodenal diverticulum. Microscopic examination of the diverticula failed to disclose the presence of either gastric or pancreatic tissue.

The 99mtechnetium pertechnetate nuclear red blood cell scan proved to be a valuable diagnostic tool in localizing the site of bleeding, from a Meckel's diverticulum, in a 41-year-old man. When peptic ulcer or colorectal disease has been excluded by panendoscopy, bleeding Meckel's diverticulum remains a diagnostic consideration, even in adults. We provide a 20-year list of bleeding Meckel's diverticula reported in adults, along with a brief discussion.

A case of true diverticulum of the pericardium is reported, with a review of the literature. A cure was effected by excision of the cystic pericardial diverticulum. Consideration of the etiology of true pericardial diverticulum is given, and possible explanation for accumulation of the fluid is suggested.

Congenital diverticula of the ureter are uncommon. They are liable to the complications of infection and stone formation but tumor has not been reported previously. A case of transitional cell carcinoma in a diverticulum of the lower ureter is described.