Emergency Presentations of Meckel’s Diverticulum in Adults

Mohammed, Ayad Ahmad; Mohammed, Mohammed Rasheed

doi:10.1155/2022/6912043

Cited by 3 publications

(1 citation statement)

References 18 publications

(16 reference statements)

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“…Surgery is the main treatment. Although the management of uncomplicated MD remains controversial, MD‘s managing in the setting of either bowel obstruction or of Littre's hernia is done according to clinical principles combined with the availability of local expertise [ 2 , 4 ]. In this work, a case of umbilical LH discovered during emergency management of obstructive syndrome, in an 11-year-old boy, was presented.…”

Section: Introductionmentioning

confidence: 99%

Umbilical Littre hernia: A rare case report of an acute abdomen

Khalifa,

Belaid,

Ghannouchi

et al. 2024

International Journal of Surgery Case Reports

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Section: Introductionmentioning

confidence: 99%

Umbilical Littre hernia: A rare case report of an acute abdomen

Khalifa,

Belaid,

Ghannouchi

et al. 2024

International Journal of Surgery Case Reports

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Symptomatic Meckel's Diverticulum in adult patients: our single center 6-year clinical experience and results

UÇANER,

ÇİFTÇİ

2023

Turkish Journal of Clinics and Laboratory

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Aim: Meckel's diverticulum (MD) is an embryological remnant that results from the incomplete obliteration of the omphalomesenteric or vitelline duct after birth and it is the most common congenital anomaly of gastrointestinal tract. MD is usually asymptomatic and presents in the pediatric population. In this study, it was aimed to analyze the clinicopathological characteristics of MD, which has an important place in the differential diagnosis of acute abdomen and is difficult to diagnose in the preoperative period, in the light of current literature and to examine the results Material and Methods: Patients diagnosed with Meckel's diverticulum and underwent surgery between January 2017 and January 2023 in the general surgery clinic were retrospectively scanned. Preoperative, intraoperative and postoperative data of the patients were examined and analyzed. Results: Sixteen of the cases were male and 6 of them were female. Comorbid disease was present in 7 cases. Abdominal pain (72.7%) was the most common symptom, while heterotopic tissue was observed in 9 cases in histopathological evaluation. Postoperative surgical complication was observed in 6 patients and the most common complication was found to be ileus (3 patients). Mortality was observed in one patient in the postoperative period. Conclusion: Meckel's diverticulum should always be kept in mind in the differential diagnosis of acute abdominal pain. Delay in diagnosis and going unnoticed during surgery increase mortality and morbidity rates, especially in symptomatic patients and pathologies associated with other causes of acute abdomen.

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A Rare Case of Meckel's Diverticulum Strangulation Complicated by Small Intestine Obstruction (Clinical Case)

Kravets,

Svistunov,

Moskalenko

2024

EUMJ

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Introduction. Meckel's diverticulum (MD) is a congenital anomaly of the gastrointestinal tract. In most cases, uncomplicated DM is silent. It is mainly diagnosed when complications arise or accidentally during diagnostic procedures or surgical interventions. A recognised effective diagnostic method is laparoscopy, which allows to assess the localisation and degree of pathological changes in the diverticulum. Treatment of complicated DM is surgical. The volume of surgery depends on the diameter of the diverticulum, the nature of complications, the prevalence of the inflammatory process at the base of the diverticulum and the ileum wall, and the spread of peritonitis. In this report, we would like to share our own successful experience of treating a patient with DM complicated by necrosis and volvulus of the small intestine. Case report. A 42-year-old male patient was hospitalised with complaints of abdominal pain, fever up to 38°C, and nausea. During the examination, the abdomen was distended, painful in all parts, spared during breathing. In the right iliac region and in the right lateral canal, there were weakly positive symptoms of peritoneal irritation, peristalsis was weakened. Ultrasound examination of the abdominal cavity revealed free fluid in the right hypochondrium and pelvic cavity, dilatation of the small intestine loops. Plain radiography of the abdominal cavity: pneumatosis of the intestine, small intestinal fluid levels. Video laparoscopy was performed to clarify the diagnosis under endotracheal anaesthesia. During the revision of the abdominal cavity, a defect of up to 5.0 cm in the mesentery of the small intestine with a large-sized and necrotic altered DM and a wrap around it of small intestinal loops with necrosis was detected. Resection of the necrotic loops of the small intestine with DM was performed with the application of a «side-to-side» intestinal anastomosis. The postoperative period was uneventful. The patient was discharged on day 10. Discussion. Due to the lack of characteristic symptoms, the diagnosis of DM, even in cases of complications, is sometimes established late, which entails problems in the further treatment of patients. Today, laparoscopy is the leading and most informative method in the diagnosis of DM. In some cases, it is the first stage of surgical intervention. Intestinal obstruction is one of the most common complications of DM. It is caused by small intestine torsion around a fixed diverticulum, nodule formation, and diverticulum invasion. Early diagnosis is important because delayed surgery increases mortality. We present a clinical case of complicated DM with symptoms typical of small bowel obstruction. The standard methods used at the first stage of diagnosis did not allow to establish the cause of intestinal obstruction. Only the use of laparoscopy made it possible to establish an accurate diagnosis. To date, the question of the need to remove an accidentally found DM remains unresolved. It is believed that an individual approach is advisable. In cases of complications, the choice of surgical intervention depends on the diameter of the diverticulum base, the severity of morphological changes in its wall and the wall of the small intestine. Conclusions. The absence of specific symptoms and low informational content of routine diagnostic methods are the reason for the untimely diagnosis of DM, which often causes the development of severe complications. Laparoscopy is the only significant diagnostic and treatment method that allows for an accurate diagnosis and, in some cases, diverticulectomy. An individual approach is recommended in the treatment of DM, depending on the clinical situation.

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Emergency Presentations of Meckel’s Diverticulum in Adults

Cited by 3 publications

References 18 publications

Umbilical Littre hernia: A rare case report of an acute abdomen

Umbilical Littre hernia: A rare case report of an acute abdomen

Symptomatic Meckel's Diverticulum in adult patients: our single center 6-year clinical experience and results

A Rare Case of Meckel's Diverticulum Strangulation Complicated by Small Intestine Obstruction (Clinical Case)

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