Search

Positive gastric mucosa Meckel diverticulum generally shows nonmoving activity in the right abdomen, which appears early in the study at about the same time of the appearance of the stomach. However, a stoma from ileostomy can result in similar findings on dynamic images. The difference between a true Meckel diverticulum and stoma can be exposed by lateral views.

A 17-year-old boy, with a background of haemophilia A, presented to hospital with an episode of brisk and painless per rectal (PR) bleeding. Initial investigation with gastroscopy and colonoscopy revealed no source of bleeding. Examination of the small bowel including MRI, CT angiogram and capsule endoscopy revealed no abnormalities. Double balloon enteroscopy (DBE) from an antegrade position was attempted, with no abnormalities noted. The symptoms persisted and DBE was attempted again from a retrograde approach and a diverticulum was subsequently noted. Laparoscopic surgery was performed identifying a diverticulum as the source of bleeding, 110 cm from the ileocaecal valve, which is more proximal than is normally seen. Histological examination revealed a Meckel's diverticulum. The case described here, although more unusual in adults, demonstrates that complete visualisation of the small bowel remains challenging and that newer modalities of enteroscopy including DBE can help aid in the diagnosis of obscure gastrointestinal bleeding., (2016 BMJ Publishing Group Ltd.)

Introduction: Meckel's diverticulum is the commonest congenital abnormality of the gastrointestinal tract. Its infrequent occurrence is mirrored by the paucity of large series of data on it in the literature. Hemorrhage, obstruction and inflammation are the three main categories of complications resulting from Meckel's diverticulum. Perforation of Meckel's diverticulum following blunt abdominal injury is very rare indeed. We present what we believe to be the first case to be published from Africa., Case Presentation: A 29-year-old Nigerian Igbo man presented with progressively worsening abdominal pain following a road traffic accident. He was a front-seat passenger traveling without a seat belt. On physical examination his abdomen was distended with guarding and rigidity. A provisional diagnosis of peritonitis secondary to perforation of intestinal viscus was made. Our patient had an emergency laparotomy, where a perforated Meckel's diverticulum was discovered. A segmental resection of his ileum and reanastomosis were done. He had postoperative surgical site infection, but was asymptomatic for three months of follow-up., Conclusion: Perforation of Meckel's diverticulum is rarely suspected as a cause of peritonitis following blunt abdominal injury. This case indicates the need to be aware of the possibility to limit morbidity associated with delayed management of such a perforation.

A Meckel's diverticulum becomes symptomatic due to complications such as hemorrhage or bowel obstruction. The presence of ectopic pancreatic tissue in the diverticulum can be associated with such complications. To our knowledge, multi-detector row CT findings of ectopic pancreatic tissue in a Meckel's diverticulum have never been reported. Here, we report the multi-detector row CT features of the ectopic pancreatic tissue in a Meckel's diverticulum., (© 2014.)

We describe the case of a 43-year-old man recently diagnosed with ileal Crohn's disease complicated by a free peritoneal perforation of a Meckel's diverticulum and the presence of enteroliths in the intestinal lumen. The coexistence of Crohńs disease, Meckel's diverticulum and enteroliths has rarely been reported. Meckel's diverticulum can hamper the management of Crohn's disease., (Copyright © 2012 Elsevier España, S.L. and AEEH y AEG. All rights reserved.)

Skip segment Hirschprung's disease (SSHD) is an uncommon variant of Hirschprung's disease where normal intestine is interspersed proximally and distally by abnormal, aganglionated intestine. These segmental changes have no well-defined embryological explanation. We present a case of SSHD in the small bowel and concomitant perforated Meckel's diverticulum, with review of the literature relevant to SSHD.

Background: A Meckel's diverticulum is a remnant of the primitive bowel and the yolk sac which occurs in 1-5% of the population. It causes problems in only very few people., Case Description: A 39-year-old man developed acute abdominal pain after eating two oranges. The cause of the pain was found during a lower abdominal laparotomy - the small bowel was obstructed by a Meckel's diverticulum and a phytobezoar composed of orange fibres. Both were removed surgically., Conclusion: A symptomatic Meckel's diverticulum should be removed; however, in an asymptomatic Meckel's diverticulum this approach is controversial. One of the problems that can arise is an obstructive ileus. Patients who in the past have had an obstructive ileus resulting from a phytobezoar are advised to avoid eating large quantities of fruit rich in fibre and to chew very well.

Meckel's diverticulum is the most common congenital abnormality of the gastrointestinal tract. In the vast majority of cases it remains asymptomatic throughout life but in about 5% of cases it gives rise to complications, namely, haemorrhage, intestinal obstruction and inflammation. A rare complication is being presented--a femoral hernia containing a strangulated Meckel's diverticulum. This is known as Littre's hernia, which often exhibits subtle variations from the norm in its presentation. Preoperative diagnosis of Littre's hernia containing Meckel's diverticulum is rather difficult; almost always, the strangulated diverticulum is first discovered during operation. The diverticulum was resected and the femoral canal closed by a polypropylene mesh plug. The patient underwent an uneventful recovery and was discharged home on the fourth postoperative day. Complications arising from Meckel's diverticulum usually occur at a young age, with the ectopic tissue present in the diverticulum frequently being the cause of the symptoms. Criteria for the resection of Meckel's diverticulum found incidentally at laparotomy have been suggested.

Purpose: The pathogenesis of gastroschisis is unknown. It may be helpful in understanding its pathogenesis to know the structural relationships among umbilical components including umbilical vessels, urachus, and vitelline structures, and thus, the authors investigated the remnants of vitelline structures in a series of cases of gastroschisis., Methods: Medical records of 41 cases with gastroschisis treated in our institute from 1979 to 2009 were retrospectively reviewed., Results: Paraumbilical bands, possible remnants of vitelline structures, were observed in 4 cases (9.8%). All 4 bands were attached to the skin edge of the abdominal defect without incorporation into the umbilical cord. The band ended at the mesentery in 3 cases and at the antimesenteric site of the ileum in the remaining case. Histologic findings showed fibrous tissues in all cases. One was possibly associated with the development of colonic atresia. Another was noticed after silo reduction when herniated bowels became strangulated by the band. The other 2 cases were uncomplicated., Conclusions: Our findings may support the recently proposed hypothesis that the developmental failure of the yolk sac and related vitelline structures to merge with or to be incorporated into the umbilical stalk might be associated with the pathogenesis of the abdominal wall defect in gastroschisis. Paraumbilical bands derived from vitelline structures may possibly cause intestinal ischemia prenatally or postnatally., (Copyright © 2010 Elsevier Inc. All rights reserved.)

The mechanisms that determine organ identity along the digestive tract in humans are poorly understood. Here we describe the rare case of a young patient who presented with congenital gastric-type heteroplasia in the midjejunum. The lesions, located along the antimesenteric midline of the gut, were made of histologically and functionally normal gastric epithelium without inflammation or in situ/invasive carcinoma. They resembled the anatomy of the lesions developing in the mouse gut as a result of haploinsufficiency of the Cdx2 homeobox gene. The lesions were devoid of CDX2 but without mutation in the coding sequence or in a cis-regulatory element required for intestine-specific expression. Combining these data with the CDX2 expression pattern established from human embryos and cases of Meckel diverticula, we propose a scenario for this patient's presentation, in which CDX2 was missing at the site of ventral closure during gut morphogenesis, with subsequent default differentiation into gastric instead of intestinal tissue. Altogether, these observations argue in favor of a pivotal role played by CDX2 in determining intestinal identity during human embryonic development, as previously shown experimentally in mice.

Meckel's diverticulum has previously been reported to be present in patients with Crohn's disease. However, the finding is typically an incidental one, and involvement of the diverticulum in the disease process is uncommon. We report a case of an adolescent with known Crohn's disease who presented with symptoms thought to be due to terminal ileitis. At the time of laparoscopy the inflammation was found to be due to involvement of the Meckel's diverticulum with Crohn's disease.

We report a one-month-old male child with a patent omphalo-mesenteric duct that regressed spontaneously in the neonatal period and resulted in a Meckel's diverticulum.

An extremely rare case of persistent omphalomesenteric duct causing small bowel obstruction is presented. A 20-year-old female patient without medical history presented with colicky abdominal pain, vomiting, absence of passage of gas and feces, and abdominal distension of 24 h duration. Physical examination and blood tests were normal. Abdominal X-ray showed small bowel obstruction. Computed tomography of the abdomen demonstrated dilated small bowel and a band originating from the umbilicus and continuing between the small bowel loops; an omphalomesenteric duct remnant was suspected. In exploratory laparotomy, persistent omphalomesenteric duct causing small bowel obstruction was identified and resected. The patient had an uneventful recovery and was discharged on the 5(th) postoperative day. Although persistent omphalomesenteric duct is an extremely infrequent cause of small bowel obstruction in adult patients, it should be taken into consideration in patients without any previous surgical history.

The authors report a case of Meckel diverticulitis secondary to an enterolith in a young man with abdominal pain, fever, and sepsis. In this rare complication, the diagnosis was made, in emergency, on 3D reconstructed images showing the tubular structure connected to the small bowel.

Abdominal fistula caused by an ingested wooden spit, which penetrated the intestinal wall and remained in the abdominal wall: a laparascopy was performed in a 41-year-old man suffering from acute appendicitis and an inflamed Meckel's diverticulum. After removal of the appendix and the diverticulum, a fistula developed in the excision channel of the left quadrant of the abdominal wall post-operatively. Despite repeated incision of the abscess in the course of 2 months, the fistula did not heal. Ultrasound examination of the abdominal wall was therefore performed. The postoperative status was without conspicuous findings. We could, however, detect a foreign body, a few centimetres long and 2-3 mm thick, displaying a smooth surface, deep down in the abdominal wall. A fistulography confirmed the diagnosis. After removal of the wooden spit, complete healing of the fistula in the abdominal wall was observed. Subsequently, the patient reported to have eaten a beef roulade, fixed with a wooden spit, 7 weeks before the abdominal operation.

Background: In this study we present our experience in the surgical treatment of complicated Meckel's diverticulum., Methods: The data of eight patients who underwent surgery due to complications of Meckel's diverticulum between 1994-2001 was retrospectively assessed., Results: There were six males and two females with a mean age of 31 years (range 13 to 65). Preoperative diagnoses were acute surgical abdomen in six and incarcerated inguinal hernias in two patients. Intraoperative diagnoses were as follows; Littre's hernia in two, diverticulitis in two, perforation of the diverticulum in one and intestinal obstruction in three patients (there was a band extending from diverticulum to the umbilicus in two patients and a mesodiverticular band in the remaining one). While diverticulectomies were performed in five patients, three had small bowel resections. The mean diameter of the diverticula was 2.3 cm (range 2 to 4) and the mean length was 3.5 cm (range 3 to 8). Postoperative intestinal obstruction was observed in one patient who had underwent diverticulectomy and subsequently a small bowel resection was performed., Conclusion: Being aware of the complications of the Meckel's diverticulum is necessary in correct timing of the surgery and selecting the proper incision in patients with acute abdomen. This will result in decreased morbidity.

This case reports the concomitant findings of carcinoid tumor within a Meckel's diverticulum presenting as an acute abdomen in an adult male. Most Meckel's diverticula remain asymptomatic throughout life, and symptomatic diverticula are virtually nonexistent in older adults. Meckel's diverticulitis is clinically indistinguishable from acute appendicitis, and abnormal or symptomatic diverticula are generally resected. Surgical treatment of Meckel's diverticula is recommended for children during exploration. However, resection is controversial in asymptomatic adults. Carcinoid tumors are the most common primary tumor of the small bowel. The duration of symptoms before diagnosis varies from 2 to 20 years, and half of all patients have incurable abdominal disease at first-look surgery. Metastatic events occur most commonly in the liver with a generally poor prognosis. Surgical resection is the treatment of choice. Both Meckel's diverticula and carcinoid tumor are rare clinical entities, and carcinoid tumors occurring within a Meckel's diverticulum are even more uncommon. Thus, the natural history is difficult to predict and treatment recommendations vary. Solitary, localized, asymptomatic nodules less than 1 cm are generally managed with diverticulectomy or segmental resection. Larger or multiple lesions require wide excision of bowel and mesentery, and hepatic resection may be required for metastatic disease.

A patient was admitted because of an intestinal obstruction. Eight years before, he underwent a laparoscopic cholecystectomy. Abdominal ultrasonography and small bowel series showed a gallstone in the small bowel that computed tomography scan failed to identify. Laparotomy showed a Meckel's diverticula and a biliary stone in the terminal ileum. In the literature, it has been shown that gallstone lost during laparoscopic cholecystectomy may be responsible for intraperitoneal abscess. In the contact of intestine, the stone may induce an obstructive abscess, a communicating abscess, a digestive fistula or a biliary ileus. During the postoperative course of laparoscopic cholecystectomy, these patients suffer from abdominal pain and fever lasting from few days to several months. Imaging shows the biliary gallstone mechanical complications induced by the stone. To avoid such complications, biliary gallstone that falls into the peritoneum during laparoscopic cholecystectomy should be removed under laparoscopy.

Background: Acute abdominal pain due to complicated Meckel's diverticulum is an unusual event. Even the presence of biliary enterolithiasis at the onset of inflamed congenital diverticulum has rarely been reported previously., Results: Despite this unusual presentation, an episode of gallstone passage through the biliary tract has not yet been described., Conclusions: Whether the stones were primarily formed in the diverticulum as enterolithiasis, or secondary to gallstone passage is discussed. The complications of Meckel's diverticulum requiring surgical treatment are reviewed, focusing on the unusual finding of biliary stones in Meckel's diverticulum and the etiogenic mechanism of enterolithiasis.

A newborn with a patent omphalomesenteric duct is described in this report. This anomaly is a very rare one. Regression of the omphalomesenteric duct occurs as a normal embryonic event in the intrauterine life between the fifth and ninth week of gestation; however, in this case regression occurred spontaneously in the neonatal period and resulted in a Meckel's diverticulum with no connection with the umbilicus. This is the first case to be reported.

Three cases of anomalies of intestinal rotation are reported in order to show the difference between chronic and acute presentations of this entity. After a short embryologic review diagnostic difficulties and surgical treatment are discussed.

Meckel's diverticulum is considered the most common diverticulum of the small intestine. Of the various complications associated with this condition, intestinal obstruction is one of the most common. Rapid diagnosis and treatment are essential. Resection of the obstructing element is the treatment of choice. The authors report on their recent experience with two patients with Meckel's diverticulum, both of whom had intestinal obstruction as the presenting complication. The authors discuss the etiology and various complications of Meckel's diverticulum and present information on the frequency of associated mortality and morbidity.

31 cases of complicated remnants of the omphalomesenteric duct are reviewed. In particular mechanical just as often as inflammatory complications are noted. There was a predominance of male infants with a mean age of 3.5 years. Surgery is recommended even for still non complicated Meckel's diverticula in childhood. There was no mortality.

Between 1966 und 1975 42 children and 46 adults were operated on Meckel's diverticulum. The diverticulum is explained as one of the possible disturbances during regression of ductus omphaloentericus. The appendicitis-like symptomatology correlates to the involvement of gastric and colonic mucosa as well as heterotopic exo- and endocrine tissue of the pancreas in the wall of the diverticulum. In 34% complications were due to inflammation, perforation, bleeding, intussusception, volvulus, gut-strangulation with ileus, ulcer, neoplasia or lesion by foreign bodies. 4 out of 88 patients died. Preoperative diagnostic fails in 75%, therefore in every case the distal gut should be inspected and every diverticulum should be resected.

In twenty years, 66 infants and children with remnants of vitelline duct requiring surgery have been admitted. The patients were classified into three groups: patient vitelline duct (20 cases); Meckel's diverticulum as the primary surgical diseases (19 patients); and Meckel's diverticulum found incidentally at surgery (27 patients). The male preponderance in the groups of patent vitelline duct and symptomatic Meckel's diverticulum was 9:1. In contrast with other data, Meckel's diverticulum requiring surgery occurred with nearly equal frequency up to fourteen years. The gravest complication in the cases of patent vitelline duct were a T-shaped protrusion of ileum and a small bowel volvulus around the fibrous cord or the patent duct; and in the cases of Meckel's diverticulum causing symptoms, intestinal obstruction, bleeding peptic ulceration or inflammation. Three deaths occurred in newborn age in connection with patent vitelline duct, and one patient died who belonged to the group of asymptomatic Meckel's diverticulum.