Encountering Meckel's diverticulum in emergency surgery for ascaridial intestinal obstruction

Abstract

BackgroundMeckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract. In children with intestinal ascariasis, the diverticulum remains asymptomatic or rarely the Ascaris lumbricoides may lead to its complications in the presence of massive intestinal roundworm load. Given that preoperative diagnosis is seldom carried out, when Meckel's diverticulum is found at laparotomy for obstructive intestinal complications of roundworm, the diverticulum should be removed as complications may occur at any time. The aim of this study was to describe the findings of concomitant presence of Meckel's diverticulum who had surgical intervention in symptomatic intestinal ascariasis in children.MethodsA retrospective case review study of 14 children who had surgical intervention for symptomatic intestinal ascariasis having the presence of concomitant Meckel's diverticulum was done. The study was done at SMHS Hospital Srinagar, Kashmir.ResultsA total of the 14 children who had ascaridial intestinal obstruction with concomitant presence of Meckel's diverticulum were studied. Age of children ranged from 4-12 years, male:female ratio was 1.8:1. Nine patients had asymptomatic Meckel's diverticulum, whereas 5 patients with symptomatic signs were found in the course of emergency surgery for ascaridial intestinal obstruction.ConclusionMeckel's diverticulum in intestinal ascariasis may pursue silent course or may be accompanied with complications of the diverticulitis, perforation or the gangrene. Incidental finding of the Meckel's diverticulum in the intestinal ascariasis should have removal.

Systematic review of epidemiology, presentation, and management of Meckel's diverticulum in the 21st century

“…Added together, obstruction, hemorrhage, and inflammation account for 69.5% to 100% of symptomatic patients in each of the largest retrospective patient series. Rarer forms of symptomatic Meckel's, including umbilical abnormalities involving the vitelline duct, [39] parasite-infections involving the Meckel's, [42] Meckelian cancers, [43] as well as uncertain cases, [28] account for the remainder.…”

A Rare Cause of Acute Abdomen: Perforation of Double Meckel’s Diverticulum

“…Meckel's diverticulum is symptomatic in 4–6% of the patients [ 5 , 6 ]. The ratio of men to women in symptomatic cases is reported to be 3/1 [ 2 , 7 ]. Most common complications include ulceration, intestinal obstruction, hemorrhage, perforation, intussusception, vesicodiverticular fistula, and malignancy [ 3 , 8 , 9 ].…”

A Prospective Hospital Based Study of Ascaris Lumbricoides in Adults: Our Ten Years’ Experience From A Highly Endemic Area of India

“…Louw 23 , in a review, found intestinal obstruction, biliary tract diseases, pancreatic diseases, peritonitis and appendicitis due to roundworms. Mishra PK et al 24 and Wani I et al 25 in their respective studies also found the similar abdominal complications and even the involvement of meckle's diverticulam. In the present study we observed near to same set of abdominal complications.…”