Meckel's diverticulitis: a rare entity of Meckel's diverticulum

Wong, Chee Siong; Dupley, Leanne; Varia, Haren; Golka, Darek; Linn, Thu

doi:10.1093/jscr/rjw225

Cited by 12 publications

(22 citation statements)

References 7 publications

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“…In the asymptomatic patient, a conservative approach is well justified giving the rarity of complications. 10 The acute abdomen in pregnancy represents a challenging presentation. While appendicitis is the most common surgical pathology encountered in this cohort, other conditions may masquerade as this including Meckel's.…”

Section: Discussionmentioning

confidence: 99%

Systematic review of Meckel's diverticulum in pregnancy

Wong

Conroy²,

Farkas³

2021

ANZ Journal of Surgery

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Introduction: Meckel's diverticulum (MD) is the most common congenital malformation in the gastrointestinal tract. Limited up-to-date evidence is available regarding MD in pregnancy. We aim to review the available pertinent literature to help support clinical decision making and patient management in the future. Materials and Methods: The search term 'Meckel's diverticulum' was combined with 'pregnant' or 'pregnancy'. Database searches of EMBASE, Medline and PubMed were conducted. All papers published in English from 01/01/1990 to 01/01/2021 were included. Simple statistical analysis (t-test) was performed. Results: Twenty-seven cases were included. Average age = 26.9 years. Average gestation = 25.1 weeks. Occurrence: first trimester = 3.7%; second trimester = 48.1% and third trimester = 48.1%. Presenting symptoms: abdominal pain 88.9%; nausea/vomiting 59.3%; fever 18.5%; abdominal distension 18.5%; haematochezia 11.1%; constipation 11.1%; haematemesis 3.7%, diarrhoea 3.7% and asymptomatic 3.7%. Mean duration of preceding symptoms = 3.4 days. Diagnostic imaging modalities utilised: ultrasound = 40.7%; CT = 25.9%; MRI = 14.8%; abdominal X-ray = 11.1% and endoscopy = 7.4%. All cases required definite surgical management: laparotomy = 65.4%; laparoscopy = 15.4%; C-section = 19.2% and unreported = 3.8%. Main intra-operative findings: perforated MD = 40.7%; intussusception with MD as a lead point = 11.1%; bleeding MD = 11.1%, inflamed MD = 11.1%; small bowel obstruction = 11.1%; gangrenous MD = 3.7%; volvulus = 3.7% and unspecified = 7.4%. Mean length from ileocolic junction = 51.7 cm. Average length of stay was 7.1 days. T-test (p-value = 0.12) when comparing management strategy. Three maternal complications and two foetal mortalities. Conclusion: MD and associated pathology are difficult to diagnose in the pregnant cohort. Current imaging demonstrates low diagnostic accuracy and a deviation away from recognised nuclear medicine investigations. Surgery appears the definitive management with both open and laparoscopic approaches utilised. Significant maternal morbidity and foetal mortality are associated with this condition.

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Section: Discussionmentioning

confidence: 99%

Systematic review of Meckel's diverticulum in pregnancy

Wong

Conroy²,

Farkas³

2021

ANZ Journal of Surgery

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“…1 The most useful method of detection of a Meckel's diverticulum is technetium -99m pertechnetate scanning depending upon uptake by heterotopic gastric mucosa. 13 The 99mTc -pertechnetate Meckel's scan has been reported as sensitivity as high as 85%, with a specificity of 95% but all diverticulum doesn't contain ectopic tissue to take up technetium and its availability at all centers limits its widespread use. 13 Management of symptomatic MD should be prompt surgical intervention with resection of the diverticulum or resection of the segment of ileum bearing the diverticulum.…”

Section: Discussionmentioning

confidence: 99%

“…13 The 99mTc -pertechnetate Meckel's scan has been reported as sensitivity as high as 85%, with a specificity of 95% but all diverticulum doesn't contain ectopic tissue to take up technetium and its availability at all centers limits its widespread use. 13 Management of symptomatic MD should be prompt surgical intervention with resection of the diverticulum or resection of the segment of ileum bearing the diverticulum. 14 In case of bleeding due to MD, the bleeding site is usually from the adjacent ileum, so segmental resection of ileum with diverticulum is required.…”

Section: Discussionmentioning

confidence: 99%

Diverse Presentation of Meckel’s Diverticulum in Pediatric Patients

Kumar

Jalan

Patowary

et al. 2018

J Coll Med Sci-Nepal

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IntroductionMeckel’s Diverticulum is the most common congenital disease and seen in 2% of population. It is difficult to diagnose preoperative, mostly seen during operation with its various presentation.Material and Methods This is a retrospective study in which all the cases diagnosed as Meckel’s diverticulum with its complication diagnosed while doing operation were included. Demographic data, clinical presentation, preoperative diagnosis, intraoperative findings, surgical procedure performed, histopathological report and postoperative follow up of patients were recorded and statistically analyzed. The aim of this study was to assess various presentation of Meckel’s diverticulum in 8 years of duration in college of medical sciences, Bharatpur Nepal. ResultsOut of 32 cases, there were 20 male and 12 female with M:F ratio1.66:1. The mean age was 8.34 ± 3.98 years. All together sixteen (50%) patients had features intestinal obstruction. Perforation was seen in 28.1% patients, intussusception in 21.8%, diverticulitis in 15.6%, small bowel volvulus around fibrous band in 18.8%, internal herniation in 9.4% and massive bleeding in 6.3% patients. The average distance from ileocecal junction was 40-60 cm. All cases underwent emergency laparotomy, presence of Meckel’s diverticulum was incidental intraoperative finding. Three cases had superficial wound infection. Small intestine mucosa followed by gastric, pancreatic and colonic mucosa were most common histological finding. The average duration of hospital stay was 5 to 8 days.ConclusionMeckel's Diverticulum is a true diverticular anomaly that may remain clinically silent for lifetime, or it may have life-threatening complications. Due to nonspecific features in case of acute abdomen, Meckel’s diverticulum and its complications should be kept as an important differential diagnosis.Keywords: intestinal obstruction; meckel’s diverticulum; volvulus.

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“…It arises from the antimesenterial border located usually 100 cm proximal to the ileo-cecal valve, has its own mesentery and blood supply from a terminal branch of the superior mesenteric artery. 2 Diverticula that contain normal ileal mucosa, it may harbor ectopic gastric tissue (~50%), duodenal Brunner's glands, pancreatic acinar tissue, colonic mucosa, endometrium, hepatobiliary tissue, or their combination. Meckel's diverticulum is usually asymptomatic, only about 2% develop a complication over the course of their life.…”

Section: Introductionmentioning

confidence: 99%

Perforated Meckel’s Diverticulum with Pancreatic and Gastric Heterotropia and Acute Peritonitis - A Case Report

Mehjabin

Kamal

Talukder³

et al. 2022

J Shaheed Suhrawardy Med Coll

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Meckel’s diverticulum, the most common congenital anomaly of small bowel although usually silent, can cause complications like intestinal obstruction, bleeding, diverticulitis, perforation etc. We report a case, which presented with acute onset of severe pain in right iliac fossa which was clinically and sonographically diagnosed as acute appendicitis. Histopathological report of appendix was non specific findings. Four days after appendectomy patient again came with features of acute abdomen. X-ray abdomen showed free gas under diaphragm. Abdomen was explored with a midline incision, a perforated Meckel’sdiverticulum was found which was managed by wedge resection and repair of the ileum. Histopathological examination of specimen revealed diverticular wall with normal appearing intestinal mucosa and muscle coat which showed two heterotrophic tissues (pancreatic and gastric ) in the wall.These also showed features of perforation and acute peritonitis. This is probably the first case of Meckel’s diverticulitis with heterotropic pancreatic and gastric tissue in Bangladesh. J Shaheed Suhrawardy Med Coll 2020; 12(2): 115-118

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Meckel's diverticulitis: a rare entity of Meckel's diverticulum

Cited by 12 publications

References 7 publications

Systematic review of Meckel's diverticulum in pregnancy

Systematic review of Meckel's diverticulum in pregnancy

Diverse Presentation of Meckel’s Diverticulum in Pediatric Patients

Perforated Meckel’s Diverticulum with Pancreatic and Gastric Heterotropia and Acute Peritonitis - A Case Report

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