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

Out of 270 children with gastrointestinal symptoms, the indications for technitium scanning were: gastrointestinal tract bleeding (165 patients), abdominal pain (99 patients) and a history of intussusception (6 patients). Thirty children had abnormal findings, while the remaining 240 patients had "normal" scans. Four of the 30 children with positive scans were not explored, while the others underwent laparotomy. Of the 26 operated patients, 12 (46%) had a Meckel's diverticulum. Nine patients (34%) had other pathologic lesions that were detected by the scan. Five had true "false positives" as no pathologic lesions were found. Of the 240 children with negative scans, 19 were eventually explored because of persistent symptoms or clinical findings. Two of these had a Meckel's diverticulum. Eleven had a negative exploration while six had other surgical lesions. Technitium scan should reliably detect around 80%-90% of Meckel's diverticula. It will also accurately exclude the diagnosis of Meckel's diverticulum in over 90% of patients.
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PMID:The abdominal technetium scan (a decade of experience). 629 68

Two middle-aged patients are reported who came to laparotomy with a presumptive diagnosis of small bowel tumour. There was no overt evidence of small bowel obstruction in either case. They were found at laparotomy to have intussusception of an invaginated Meckel's diverticulum. This condition should be considered in the differential diagnosis of ileal tumours.
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PMID:Intussusception of invaginated Meckel's diverticulum. 648 39

Strong evidence in the literature suggests that improvements in the management and outcome of small bowel obstruction result from early diagnosis, better fluid and electrolyte replacement, use of antibiotics, and early surgical intervention. This paper reviews the outcomes of 49 male and 31 female patients who were operated on for small bowel obstruction. The average age was 38 years (range, 3 to 87 years); the average hospital stay was 13 days. There was one death. The causes of obstruction included postoperative adhesions (78 percent), strangulated external hernia (11 percent), gangrenous bowel (4 percent), intussusception (2.5 percent), appendiceal mass (3.5 percent), and Meckel's diverticulum (1 percent). The outcome was worse with late presentation, perforation or gangrene of the bowel, and delayed surgery.
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PMID:Small bowel obstruction: review of nine years of experience. 650 26

11 cases of intussusception in adults, including 9 treated by operation, are discussed. The cause of the intussusception was a malignant lesion in 7 and a benign lesion in 2 cases. In 2 patients, reposition was achieved with the aid of a barium enema. Aetiology and clinical and radiological features are discussed. In view of the high incidence of pre-existent lesions and the risk of perforation at reposition with the aid of a barium enema, surgical therapy is indicated. The pre-existent lesions found at operation and pathological anatomical examination were: malignant lymphoma (4 cases), caecal adenocarcinoma (2 cases), leiomyofibroma of the ileum (1 case), caecal endometriosis (1 case), carcinoid appendix (1 case) and Meckel's diverticulum (2 cases).
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PMID:Intussusception in adults. 698 49

Pancreatic heterotopia is a developmental anomaly. When it produces complications, symptoms depend on the site of the lesion and may reflect the whole range of pathology affecting pancreatic tissue. In the ileum, pancreatic heterotopia is usually associated with a Meckel's diverticulum and may cause intestinal obstruction by intussusception. Isolated ileal pancreatic rests are rare and usually are discovered incidentally during surgery for other conditions. A case of a polypoid mass in the ileum containing aberrant pancreatic tissue that had been causing recurrent small bowel obstruction is described. Resection and primary anastomosis were curative.
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PMID:Pancreatic heterotopia--a rare cause of bowel obstruction. 724 42

In 1978-1988 operations were performed on 92 children: 35 with diverticulitis, 7 with intestinal intussusception, 5 with hemorrhage from an ulcer of the diverticulum, 13 with strangulation or mechanical ileus, 2 with strangulated Littre's hernia, one with torsion of the omentum, 22 with secondary diverticulitis, and in 7 children Meckel's diverticulum was a chance finding during other operations in the cavities. Boys accounted for 60.9' (56) of cases. There were 12 children under one year of age, nine from 1 to 3 years, 17 from 3 to 5 years, 17 from 5 to 7 years, and 12 children aged from 7 to 10 years. The clinical manifestations depended on the pathological changes developing in Meckel's diverticulum. A clinical picture of acute appendicitis developed in diverticulitis, six children had a typical picture of intussusception, and one child had a picture of acute abdomen. Anemia and a stool with dark blood were encountered in hemorrhage from a diverticular ulcer. Seven out of 13 children with ileus had a pronounced clinical picture, in the remaining 5 it was unclear and resembled that of acute appendicitis. Meckel's diverticulum was suspected before the operation in 17 (9.95%) patients. The Volkovich-Dyakonov laparotomy approach was used in 64 children, a pararectal incision in 9, a transrectal incision in 15, a median incision in one patient, hernio-laparotomy was conducted in one and Shpizi's operation in 2 children. Diverticulectomy was accomplished by the oblique-transverse method in 79 children, by the wedge techniques in 5, by the purse-string method in 2 patients, and resection of the intestine with the diverticulum was conducted in 5 children.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Meckel's diverticulum in children]. 767 99

The majority of cases of per rectal haemorrhage (PRH) are due to colorectal causes within the diagnostic reach of the colonoscope. However a few cases are from the small bowel which may pose difficulty and delay in diagnosis. We reviewed 1489 patients with PRH from 1989 to 1993 and identified 10 cases of bleeding originating from the small bowel (0.7%). These were diagnosed when both the colonoscopy and upper gastrointestinal endoscopy were negative or by observing blood coming through the ileo-caecal valve. The causes were Meckel's diverticulum (4), leiomyoma (1), intussusception (1), lymphoma (1), carcinoma (1), Crohn's disease (1) and vasculitis (1). Six cases presented with active bleeding and haemodynamic instability; 4 had chronic bleeding associated with anaemia. Bleeding from Meckel's diverticulum could be differentiated by age, mid-20s or younger compared with mid-40s or older of non-Meckel's cases. Small bowel causes need to be considered in PR bleeding unexplained on colonoscopy and oesophagogastroduodenoscopy findings. A 99mtechnetium isotope scan is most likely to be of help in the young adult but from mid-life onwards, however, other techniques such as small bowel barium studies are required.
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PMID:Small bowel causes of per rectum haemorrhage. 774 1

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

Meckel's diverticulum is one of the primary concerns in the differential diagnosis of the pediatric patient with massive, acute gastrointestinal bleeding, intussusception, or abdominal pain of uncertain cause. The hospital course of two children with Meckel's diverticulum, successfully treated by laparoscopic excision, is presented, along with details of the operative procedure. Both patients recovered from the procedure without incident and were discharged at 24 and 48 hours after surgery. The authors believe a laparoscopic approach is safe and effective in the diagnosis and treatment of Meckel's diverticulum.
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PMID:Laparoscopic diagnosis and excision of Meckel's diverticulum. 801 1

Acute appendicitis is the first cause of emergency surgery in children. Actually, emergency abdominal sonography has evolved in differential diagnosis of acute appendicitis in children to differentiate it from other causes of acute abdomen as mesenteric lymphoadenitis, acute right pyelonephritis, acute diverticulitis in Meckel's diverticulum, intestinal intussusception, regional enterits, primary peritonitis, anaphylactoid purpura of Henoch-Schonlein. The aim of this study is the evaluation of the usefulness of abdominal sonography in diagnosing acute appendicitis in our current series of pediatric patients. We have operated 102 patients afflicted by appendicitis admitted to the pediatric department of Ospedale San Raffaele, Milano in a period of 5 years and operated on for appendectomy. In the last 2 years 36 patients were evaluated with abdominal sonography. This diagnostic tool showed in 34 (94.4%) a liquid effusion, sometimes thick of the right iliac fossa. In 2 patients the appendix had thickened layers, was edematous and the lumen was clearly filled with debris. Abdominal sonography has given a clear cut picture of the acute inflammatory process of the appendix. None of these patients has suffered from septic or obstructive complications. Mean duration of hospital stay was 6.35 days (3-15 days). Differential diagnosis of acute appendicitis can be extremely variable, from simple, paradigmatic situations to the most intriguing ones. This concept is well emphasized by William Silen when he says that "differential diagnosis of acute appendicits is an encyclopedic compendium of every abdominal disease that causes pain" in the 11th edition of Harrison's Principles of Internal Medicine.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Current diagnostic-therapeutic trends in treatment of pediatric appendicitis]. 803 58


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