Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0153429 (Meckel's diverticulum)
 1,196 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A total of 32 histologically documented cases of heterotopic pancreas was found in a review of the records of the department of pathology at the Chang Gung Memorial Hospital between 1977 and 1987. This review was done to ascertain the clinical significance of this uncommon entity. In 14 patients (44%), the aberrant pancreatic tissue was symptomatic; in the other 18 (56%), it was found incidentally. In the symptomatic group, the heterotopic pancreatic tissue was found in a duplication cyst of the ileum in one patient, in the common bile duct in one, in a Meckel's diverticulum in four, in the stomach in three, in a congenital duodenal diaphragm in one, in the duodenum in three, and in the ileum in one. The majority of heterotopic pancreatic tissue in the asymptomatic group was encountered in the jejunum (15 patients). Symptoms were related to complications, including obstruction of the common bile duct, mucosal ulcer with hemorrhage, intussusception, and intestinal obstruction, but not to pathologic conditions of the pancreas itself, such as pancreatitis or pancreatic cyst or neoplasm. In all of the clinically significant cases, the clinical symptoms disappeared completely after surgical removal of the aberrant tissue. In 28 cases (87%), diagnosis was made by frozen section during operation. Preoperative diagnosis of aberrant pancreas was not made in any of the cases. Histologically, all cases showed pancreatic excretory ducts; in 31 cases (97%), exocrine glands were present, and in 27 cases (84%), islets of Langerhans were discernible. There was no relationship between symptoms and the presence of islets, acini, or ducts. Mallory's phosphotungstic acid-hematoxylin stain was used to demonstrate zymogen granules in the acinar cells, and insulin, glucagon, and somatostatin were demonstrated with the horseradish peroxidase-antihorseradish peroxidase immunocytochemical staining technique; islets of Langerhans were also identified. Technetium Tc 99m scintigraphy was used to detect the bleeding source in a Meckel's diverticulum and an enteric duplication associated with ectopic gastric mucosa.
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PMID:Pancreatic heterotopia: a reappraisal and clinicopathologic analysis of 32 cases. 305 29

Approximately 4% of patients with Meckel's diverticulum will experience complication, the most common of which are intestinal obstruction, gastrointestinal bleeding, acute inflammation, and perforation. We report an extremely rare complication of perforated Meckel's diverticulum which presented as hemoperitoneum.
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PMID:Hemoperitoneum from perforated Meckel's diverticulum. 323 71

Seven patients with clinically suspected Meckel's diverticulum were examined. The symptoms of Meckel's diverticulum are variable, ranging from mild recurrent or severe acute gastrointestinal bleeding to intestinal obstruction and acute peritonitis. The authors evaluate the diagnostic results and suggest guidelines to choose the most appropriate radiological procedures, according to the clinical pattern: barium meal, enteroclysis and scintigraphy (99mTc) in patients with mild bleeding; mesenteric angiography in case of severe bleeding. The possibility of false negatives and positives is then discussed.
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PMID:[Radiological diagnosis of Meckel's diverticulum]. 325 6

Meckel's diverticulum is a cause of significant morbidity and mortality. Often this is related to the delay in diagnosis. Based on a US population of 200 million people and a 2% incidence, there are 4 million Meckel's diverticula present waiting to cause symptoms. Considering that most Meckel's diverticula are asymptomatic and that many authors have described the condition as a great mimic, the diagnosis is often quite elusive. Therefore, a high index of suspicion is needed to diagnose Meckel's diverticulum correctly and expeditiously as the source of disease in the patient with an often unclear abdominal presentation. The difficulty with diagnosis should be lessened if one considers that Meckel's diverticulum presents largely in the male and younger age groups with the three major symptom complexes of bowel obstruction, gastrointestinal bleeding, and inflammation. Use of 99mTc pertechnetate scintigraphy appears to be the diagnostic study of choice if Meckel's diverticulum is suspected and the patient is clinically stable. When one considers the potential for bad outcome if Meckel's diverticulum is missed in the setting of possible obstruction or hemorrhage (i.e., bowel infarction or exsanguination), a high index of suspicion and diagnostic aggressiveness is warranted. Lastly, if one thought is to be left behind, it should be: "Meckel's is a great mimic that must be considered in all cases of intra-abdominal disease in which the cause is not readily apparent."
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PMID:Meckel's diverticulum. 328 86

The management of Meckel's diverticulum (MD) incidentally detected in adults remains controversial. To assess the risk involved in excision of such diverticula and the incidence of complications arising from MD in adult life, we analysed 260 cases of MD found at laparotomy in a baseline population during a 15-year period. There were 148 symptomless and 112 symptom-producing diverticula, with intestinal obstruction as the most common complication. Assuming a 2 per cent general incidence of MD, the complication rate in these adult patients was 0.03 per cent per year. The calculated lifetime risk of complication from MD was 3.7 per cent at age 16 years, falling to zero in old age. Excision of an incidentally detected MD entailed a 6 per cent rate of major complications. Twenty-eight symptomless diverticula were not excised, and follow-up revealed no complications in these cases. In adults an incidentally discovered, symptomless Meckel's diverticulum should be left in place.
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PMID:Meckel's diverticulum in the adult. 348 84

Gastrointestinal bleeding from Meckel's diverticulum resulted in small bowel obstruction by thrombus in two patients with acute myelogenous leukemia during bone marrow aplasia and recovery from induction chemotherapy. Although gastrointestinal symptoms and complications are common in acute leukemia, these two cases are unique and describe a new syndrome that requires prompt recognition and surgical intervention. The complication of localized bowel obstruction by intraluminal thrombus is heretofore unreported.
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PMID:Intraluminal thrombus and bowel obstruction in acute leukemia due to bleeding Meckel's diverticulum. 348 78

Of 217 children with vitelline duct anomalies, 85 (40%) had symptomatic lesions (mean age, 2.4 years). Forty-eight patients presented with rectal bleeding; 28, with intestinal obstruction; five, with abdominal pain; and four, with bilious umbilical drainage. An asymptomatic Meckel's diverticulum was discovered incidentally at laparotomy in 132 children. Surgical therapy included bowel resection in nine patients with volvulus, four with intussusception, seven with bleeding, three with vitelline cysts, and one with a perforation. Diverticulectomy was performed in 189 cases, and excision of a patent vitelline duct was accomplished in four neonates with umbilical drainage. Ectopic gastric mucosa was present in all 48 patients with bleeding and in four of five with inflammation but in only two asymptomatic specimens. More than one third of the cases were symptomatic and presented in younger patients. This suggests that elective resection of asymptomatic vitelline remnants in early childhood is reasonable at the time of laparotomy for other conditions.
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PMID:Vitelline duct anomalies. Experience with 217 childhood cases. 349 50

Meckel's diverticula were removed from 49 adult patients during a 15 year period. In 24 (49 per cent) of the patients the diverticulum was the cause of symptoms while in the remaining 25 it was an incidental finding at laparotomy. Of the symptomatic patients, 10 had acute inflammation of their diverticula, 8 presented with small bowel obstruction (in 4 cases due to fibrous bands) and 4 attended because of gross rectal bleeding; of the 2 remaining patients one was found to have intussusception of Meckel's diverticulum into the terminal ileum whilst the other had a nodule of calcified material lying within a partly gangrenous vitellointestinal duct. There was no operative mortality in the series. Heterotopic tissue was noted histologically in six Meckel's diverticula, all of which produced symptoms. The importance of considering a diagnosis of Meckel's diverticulum in the young adult presenting with acute small bowel obstruction or rectal bleeding is emphasized.
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PMID:Meckel's diverticulum in the adult. 387 76

A case of a primary lymphoma of Meckel's diverticulum in a 6-year-old Iraqi boy presenting clinically as acute appendicitis is reported. Exploration revealed a ruptured gangrenous Meckel's diverticulum with an ileo-ileal intussusception at the diverticulum origin. A fairly comprehensive search through the English language literature has failed to reveal any other report of a primary lymphoma of Meckel's diverticulum leading to acute intestinal obstruction.
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PMID:Primary lymphoma of Meckel diverticulum: a case report. 396 85

Two young children presented with acute small bowel obstruction associated with closed loop ileal obstruction caused by Meckel's diverticulum and vitello-intestinal duct remnant respectively. In each, resection of the vitelline remnant and ischaemic ileum with primary small bowel anastomosis resulted in good recovery.
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PMID:Closed loop intestinal obstruction due to vitello-intestinal remnants. 403 72


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