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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report the laparoscopic resection of a perforated Meckel's diverticulum (MD) found in a 14-year-old boy who presented with abdominal pain and nausea. There was rebound tenderness in the right lower quadrant of the abdomen, which appeared suspicious for acute appendicitis. The patient was referred to the operating room, and laparoscopic appendectomy was performed. With the appendix showing no macroscopic signs of inflammation, laparoscopy was continued and a perforated MD was identified 50 cm proximal to the ileocecal valve. The findings included pus and localized peritonitis between the ileal loops adjacent to the perforation site. The diverticulum was longitudinally resected with an Endo-Gia stapler. The histopathologic workup confirmed the diagnosis of a perforated MD. The patient completely recovered and was discharged 8 days after the procedures. At this writing, he is completely asymptomatic 6 months later. We conclude from our observation that laparoscopic resection of a perforated MD can be performed safely even when localized peritonitis is present. Inspection of the small intestine should be performed to exclude a symptomatic or perforated MD when the appendix does not show any signs of acute appendicitis.
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PMID:Laparoscopic resection of perforated Meckel's diverticulum in a patient with clinical symptoms of acute appendicitis. 1208 34

Meckel's diverticulum is reported in only 1 or 2% of the population. In most cases, it is free of clinical symptoms. The diagnostic modalities are effective in only 60-70% of all cases. The diagnostic laparoscopy is a safe and effective method for patients suffering from unclear abdominal pain with the option of a definitive surgical therapy. We describe the case of a 10-year-old girl with recurrent abdominal pain caused by a chronic subileus due to a Meckel's diverticulum in combination with a fibrous cord from the base of diverticulum to the mesenterial root. Both were resected in a laparoscopic technique.
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PMID:Meckel's diverticulum: a disease associated with a colored clinical picture. 1243 27

Stromal tumors are rare neoplasms of the small bowel that locate in Meckel's diverticulum with high preference. Perforation of those tumors is very uncommon. There are 96 cases reported in current literature, including only 6 perforations. The diagnosis of that kind of tumor is very difficult because of lack of pathognomonic signs and symptoms. The clinical presentation include abdominal pain, intestinal bleeding, abdominal mass, intestinal obstruction and less commonly, acute perforation. We report the case of a 61-years old patient with a poorly differentiated stromal tumor in a perforated Meckel's diverticulum. The difficulty of identifying a stromal tumor preoperatively and the therapeutic options are emphasised. It is suggested that an aggressive attitude should be taken in the preoperative management of any patient over 50 years of age who presents with melena and abdominal pain.
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PMID:Stromal tumor in a perforated Meckel's diverticulum: a case report. 1252 Aug 47

An adult case of obstruction of the ileum caused by a loop formation of Meckel's diverticulum is described. The patient, having severe abdominal pain and vomiting, was diagnosed as having ileus. A roentgenogram with a contrast medium showed severe obstruction at the mid part of the ileum. From findings of elective laparotomy, adhesion between the inflammatory end of Meckel's diverticulum and the corresponding mesenterium had formed a loop, which had clasped the distal part of ileum. We here warn that Meckel's diverticulum forming a loop is a cause of obstruction of the ileum in adults.
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PMID:A loop formation of Meckel's diverticulum: a case with obstruction of the ileum. 1283 11

Chronic intussusception as a cause of persistent abdominal pain in children is often an overlooked diagnosis. Here we present an eight-year-old boy, who at the age of three years had an acute intussusception reduced hydrostatically with barium and who subsequently had been extensively investigated both in Wales and in Switzerland, for persistent colicky abdominal pain. He was found to have chronic intussusception, with a Meckel's diverticulum being the cause of his symptoms.
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PMID:Lessons to be learned: a case study approach. Chronic intussusception in childhood. 1452 57

A Meckel's diverticulum is one cause of small bowel obstruction in the virgin abdomen. A 17-year-old female presented with a 24-hour history of lower abdominal pain and emesis. Radiological imaging studies revealed a high-grade partial small bowel obstruction. A diagnostic laparoscopy was performed revealing a bowel obstruction secondary to a Meckel's diverticulum. The diverticulum was resected using an endovascular GIA stapler. The patient was discharged on postoperative day 3, tolerating a regular diet. Laparoscopy is a useful diagnostic and therapeutic tool for a patient with a small bowel obstruction with an unclear etiology.
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PMID:Laparoscopy for treating a small bowel obstruction due to a Meckel's diverticulum. 1455 15

A 13-year-old female presented with recurrent, right-sided abdominal pain since the age of 2 years. Examination showed a tender, cylindric mass in the right lower quadrant. Ultrasound and MRI revealed an ileocolic intussusception. On laparotomy, there was an ileo-ileal intussusception due to a 3.8-cm polypoid tumor about 40 cm proximal to the ileocoecal valve. Histology showed polypoid heterotopic gastric mucosa with no Meckel's diverticulum. To our knowledge, only 12 cases of intussusception of heterotopic gastric mucosa in the ileum without Meckel's diverticulum have been reported in literature. This case adds to this small list and represents a possible cause of intussusception.
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PMID:[Differential diagnosis of acute appendicitis and ileus. Invagination due to polypoid heterotopic gastric mucosa in the ileum without Meckel diverticulum]. 1460 39

Meckel's diverticulum is an uncommon cause of intestinal obstruction in adult life. Rarely Meckel's diverticulum is complicated by a mesodiverticular band, which is believed to be a remnant of a vitelline artery. When this abnormality occurs it is associated with high mortality. We present a case of a 48-year-old man with increasing abdominal pain and vomiting for 3 days. Meckel's diverticulum was not taken into diagnostic consideration, and the man died. Autopsy revealed a Meckel's diverticulum with a mesodiverticular band and intestinal obstruction. Histological examination of cross sections of the mesodiverticular band showed the presence of an artery. Because of the high mortality of this rare anatomic anomaly in adults, we find the case of interest.
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PMID:Meckel's diverticulum and intestinal obstruction--report of a fatal case. 1464 28

Surgical emergencies can be missed easily in children, who are not always able to volunteer relevant information. Awareness of the entities discussed in this review might help the EP uncover subtle clues to early diagnoses that might not be initially apparent. Ill-appearing children who have abdominal pain and vomiting should be considered to have ischemic or necrotic bowel until proven otherwise. Possible diagnoses include volvulus, intussusception, and necrotizing enterocolitis. Bilious vomiting, especially in a young infant, should be considered to be an indication of a high bowel obstruction such as midgut volvulus, which warrants immediate surgical consultation. Significant rectal bleeding with abdominal pain can result from intussusception, volvulus, or an inflamed Meckel's diverticulum. Rectal bleeding with unstable vital signs can result from an upper GI bleed (eg, peptic ulcer disease). Painless rectal bleeding can result from a Meckel's diverticulum, polyps, arteriovenous malformation, or a tumor. Examination of the genitalia is imperative, especially in boys, to exclude the possibility of an incarcerated hernia or testicular torsion.
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PMID:Abdominal surgical emergencies in infants and young children. 1470 13

Meckel's diverticulum is the most common congenital anomaly of the small intestine, occurring in about 2 % of the population. The most common complications associated with a Meckel's diverticulum include obstruction, bleeding, and inflammation (7, 9, 11, 18-20). The estimated lifetime risk of developing symptoms with a Meckel's diverticulum is 4-6 % (16), with the risks of complications decreasing with age. Stones within Meckel's diverticulum are recognized as a rare complication in the adult population (13,15). However, it has not been reported in the pediatric age group. The authors describe a 19-month-old male who presented with intermittent abdominal pain and vomiting, chronic microcytic anemia and a calcified stone in the lower abdomen, who was found to have a Meckel's enterolith.
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PMID:Migrating calcified enterolith and chronic anemia: an unusual case presentation of a Meckel's diverticulum. 1563 Jun 49


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