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Query: UMLS:C0153429 (Meckel's diverticulum)
 1,196 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We present two cases in which complication of a Meckel's diverticulum were dealt with, and in one case diagnosed using the laparoscope. One was a large bleeding diverticulum containing ectopic gastric mucosa, with the diagnosis suggested preoperatively, confirmed laparoscopically, and the pathology resected extracorporeally. The second was a partial intermittent small-bowel obstruction due to torsion around the mesodiverticular band, diagnosed and resected via the laparoscope. The literature of Meckel's diverticula and complications is reviewed, with open and laparoscopic treatment options. Although uncommon, many cases of Meckel's diverticulum may be quite suitable for laparoscopic diagnosis and treatment.
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PMID:Laparoscopic treatment of Meckel's diverticulum. Obstruction and bleeding managed with minimal morbidity. 748 74

Laparoscopy in the emergency setting is a logical extension of this technique. Open laparoscopy is particularly useful in the management of the acute abdomen. In our institution, after a sequential work-out that includes physical examination, laboratory data, plain abdominal roentgenograms and ultrasonography, diagnostic laparoscopy is advocated. We present the laparoscopic treatment of an intestinal obstruction caused by a volvulus around Meckel's diverticulum. The efficacy and safety of the diagnostic and/or therapeutic laparoscopic procedures in the emergency setting are discussed.
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PMID:Laparoscopic management of volvulated Meckel's diverticulum. 773 47

Meckel's diverticulum is the most prevalent anomaly of the gastrointestinal tract, found in about 2% of the general population. Most are asymptomatic; but most frequent complications are intestinal obstruction, diverticulitis and lower gastrointestinal bleeding. A 33-year-old man was operated on for mechanical small bowel obstruction caused by a large Meckel's diverticulum filled with a phytobezoar. This mechanism of obstruction is rare. When the history of a patient without previous intestinal operations, as in this case, raises the possibility of phytobezoar, the probability of congenital anomaly is high.
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PMID:[Intestinal obstruction due to phytobezoar in a Meckel's diverticulum]. 781 44

Intussusception is commonly the etiology of intestinal obstruction in infants and children. To investigate demographic data, clinicopathologic features and therapeutic prognosis of patients with intussusception, we reviewed 361 intussusceptions in 333 patients over an 11-year period. Most patients were below two years of age and there was a male preponderance of 1.6:1. There was no seasonal difference between the number of cases. The clinical triad of vomiting, abdominal colicky pain and bloody stools was manifested in only one-third of our patients. Secondary intussusception contributed to 6.6% of cases and Meckel's diverticulum was the most common pathologic cause. Positive findings were recorded in 82% of 67 patients undergoing sonographic examination. Intussusception of the ileo-colic type was most frequently encountered. Most patients (79%) were diagnosed within 48 hours and almost all cases underwent primary barium enema reduction. The success rate was 45%. Laparotomy was performed in 207 patients (57%) refractory to enema reduction or with critical illness, and intestinal resection was required in 28 (14%). Long-standing duration of illness (> 24 hours), positive clinical triad, positive pathologic lead point, and radiologic finding of bowel obstruction were identified as risk factors leading patients to surgical reduction (p < 0.001). Postoperative complications and recurrent intussusception developed in some patients, and the overall mortality was 0.6%. The clinical characteristics of intussusception in children generally remained unchanged as compared to previous reports. Early identification of patients with risk factors for surgical treatment is important to decrease the need for intestinal resection.
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PMID:Intussusception in infants and children: risk factors leading to surgical reduction. 785 36

Laparoscopy in the emergency setting is a logical extension of this technique. Open laparoscopy is particularly useful in the management of acute abdomen. In fact, after a sequential work-out that includes physical examination, laboratory data, plain abdominal x-rays and ultrasonography, diagnostic laparoscopy is advocated. The Authors herein report a case of intestinal obstruction (volvulus due to Meckel's diverticulum) treated with laparoscopy. The efficacy and safety of the diagnostic and/or therapeutic laparoscopic procedure in the emergency setting are discussed.
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PMID:[Laparoscopic diverticulectomy for ileal volvulus on Meckel's diverticulum]. 806 Jul 82

Small bowel obstruction, excluding postoperative adhesive ileus, in patients > 1 month old treated between June 1982 and May 1992 at Gunma Children's Hospital Medical Center is reviewed. There were 32 patients, 22 boys and 10 girls, whose ages ranged from 1 month to 6 years (median 9 months). Intussusception was the most frequent cause of obstruction and was seen in 17 patients (53.1%). Causative lesions were identified in five patients, and were ileal duplication cysts in four and Meckel's diverticulum in one. Incarcerated inguinal hernia and mesenteric cysts resulted in bowel obstruction in six and three patients, respectively. Other causes included mesodiverticular band, ileal volvulus without malrotation, abnormal adhesion of omentum, abnormal band, vitelline duct remnant and trapping in a mesenteric defect. As for the age distribution, there was no significant correlation between the causes of obstruction and the age of patients. Ultrasonography was useful in differential diagnosis, and this modality should therefore be used in every patient with signs of small bowel obstruction.
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PMID:Small bowel obstruction in children: review of 10 years experience. 810 28

The authors present 40 cases of Meckel's diverticulum in pediatric patients (average age 6.8 years old). 31 of these (77.5%) were discovered casually in surgery and the other nine (22.5%) presented specific symptoms (three intestinal intussusceptions, three perforations, one hemorrhage, a wet umbilicus and an intestinal obstruction). In this group, seven abdominal radionuclide scan were practiced with 99mTc, resulting in two positive diagnosis (28.5%). All patients were treated with short ileal resection. The histopathological study revealed in nine cases (22.5%) the presence of gastric ectopic mucosa and, in one of them, pancreatic tissue was also found. The only morbidity was a postoperative intestinal obstruction that occurred several months later and that required surgery. The mortality was zero and the average hospital stay was 8.6 days.
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PMID:[Meckel's diverticulum in childhood. Personal experience and actualization]. 820 23

An unusual cause of small bowel obstruction associated with Meckel's diverticulum is described in two boys, aged 10 and 11 years. The causal factor was a phytobezoar lodged in the diverticulum in a Y-shaped "pantaloon" fashion.
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PMID:"Pantaloon" phytobezoar: an unusual cause of intestinal obstruction associated with Meckel's diverticulum. 827 Mar 95

A descriptive and retrospective study was realized during a period of eleven years from January 1983 to December 1993. There were found 101 cases, of which 75.25% were Meckel's diverticulum complicated. The incidence found was of 1.2%. The 89.5% of the complicated cases were less than 10 years old, and the 47.4% were less than 2 years old. The most frequent symptoms were: abdominal pain (68.4%), vomiting (68.4%), fever (47.3%), and abdominal distention (39.4%). The congenital anomalies presented in 17.8%, were: intestinal malrotation, congenital bands, hernia inguinal and omphalocele. The most common complications were: intestinal obstruction (47.4%), diverticulitis (19.7%), lower digestive hemorrhage (15.8%), and intestinal perforation (14.5%) of the cases. The heterotopic tissue was present in 20.7% cases. In our Institute, the age's group less than 2 years old, presented more complicated cases (p < 0.01). The intestinal obstruction was the most common picture (p < 0.001). The lower gastrointestinal hemorrhage was the second complication in patients less than 2 years old (p < 0.05). We found a strong association with other congenital anomalies.
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PMID:[Clinical characteristics of Meckel's diverticulum in a population of children]. 858 Apr 53

Meckel's diverticulum (MD) is the most common congenital anomaly of the small intestine, occurring in up to 4 percent of the population. The majority of MD cases are discovered incidentally; however, they can occasionally cause serious bleeding or obstructive or inflammatory complications. We reviewed the charts of 58 patients with MD from 1984 to 1994 collecting data on age, sex, presentation, therapy, pathology, and surgical complications to try to identify factors suggestive of the need for surgical therapy and the associated morbidity and mortality of resection. There was a 1.3:1 male:female ratio, and although patients with MD were found at all ages, the majority were found in patients in the 4th and 5th decade of life. Forty-five of 58 were incidental, and 13 of 58 were symptomatic. The most common symptom was bowel obstruction (10 of 13). Forty-five of 58 MD cases were managed surgically, 71 percent by diverticulectomy and the remainder by segmental resection, with no associated morbidity or mortality. Symptomatic patients were more often male (77 vs 23%; P 0.06, Fisher's exact test), more often had ectopic mucosa (31 vs 16%; P, not significant), and were evenly distributed over all ages. These data suggest that, with the possible exception of male sex, there is no factor predictive of the development of symptoms in incidentally found MD. In light of this finding, the low operative morbidity and mortality, and the even age distribution in patients with complications of their MD, we recommend that MD be resected when found incidentally in the absence of an absolute contraindication.
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PMID:Meckel's diverticulum: a ten-year experience. 912 58


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