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)

Internal abdominal hernias develop when one or more viscera extrude through an intraperitoneal orifice but remain within the peritoneal cavity. The orific may be normal (Winslow's foramen) or paranormal (peritoneal fossae: paraduodenal, ileocecal, inter- and mesosigmoidal, paracolic, supravesical, of the large ligament of uterus). All these hernias possess a sac and are true hernias. The orifice may also be abnormal: pathologic origin if formed in a mesentery or an omentum (trans-mesenteric, trans-mesocoloic, trans-omental, by colo-omental disinsertion) or in the form of an anomalous orific if it occurs in a congenital anomaly of a ligament (falciform ligament of liver) or a mesentery (mesentery of Meckel's diverticulum): all these hernias lack a sac and are "internal prolapses or procidentia". Of the 14 cases presently reported, 6 were hernias through a paranormal orifice: 2 left and 2 right paraduodenal, 1 intra-mesosigmoidal and 1 retrocecal; 6 were hernias through a pathologic orifice: 2 trans-mesenteric, 1 in the posterior cavity through a colo-omental dissinsertion hole and 3 trans-omental, and 2 were hernias through an anomalous orifice from absence of the falciform ligament of liver. Incidence of these hernias reported in the literature is between 0.2 and 0.9% of autopsies and 0.2 and 2% of parietal hernias, findings in our series being 0.098% (14 of 14,199 cases) of laparotomies and 0.32% (14 of 4,374 cases) of parietal hernias. Of 1,871 cases described in the occidental or near occidental literature (in French, English, Italian or German), 160 (8.55%) were hernias through Winslow's foramen, 1035 (55.31%) through a para-normal orifice and 676 (36.1) through an abnormal orifice (pathologic and anomalous). The sex ratio showed a male prevalence (3:2), age distribution demonstrating the onset of internal hernias at all ages with a preference for the 5th decade and a mean age of 46 years. Symptomatology was totally non specific, subacute to acute occlusive symptoms or even signs of already installed necrotizing-peritonitis being detected in 80 to 90% of cases. In 10 to 15% of patients the hernia was an unexpected finding during laparotomy for another affection, an almost typical feature of the largest para-normal hernias, the paraduodenal hernias. Preoperative diagnosis is practically impossible, and in many cases cannot be made because of time restriction, but it is sometimes possible with the largest hernias after a longer sub-occlusive period by radiologic, arteriographic and scan imaging. However, the primary task of the surgeon is not so much to establish the diagnosis as to assess the need for urgent operation. Hernias provoking large displacements of viscera can even make intraoperative diagnosis difficult with subsequent errors, and surgeons must recognize all possible types of these hernias, especially those passing through a para-normal orifice, and must be able to pinpoint the fixed guiding points. They must also work in as large an operative field as possible and should therefore always start by a median infra-supra-umbilical laparotomy to allow its maximum extension. Reduction of herniated viscera can be simple, by gentle traction, or difficult requiring dilatation of the hernial orifice and/or opening of the sac.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Internal hernia of the abdomen. Apropos of 14 cases]. 834 13

Strangulated femoral hernia is a common surgical emergency. The contents of the hernial sac commonly include omentum and small bowel, but, occasionally, strangulation of other organs such as Meckel's diverticulum, stomach, ovary, or appendix may occur, resulting in unusual clinical presentations. We report of a case with strangulated femoral hernia containing the uterus and both ovaries, and this is the first report of such a case. We believe that it is important to take into consideration herniation of the uterus and ovaries with omentum or small bowel into the femoral canal to prevent various complications related to the reproductive functions of the patient.
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PMID:Femoral hernia containing strangulated ileum along with the uterus and both ovaries: a first case report. 2150 70

Acute abdominal pain in pregnancy remains a surgical conundrum. A 25-year-old primigravid at 29 weeks gestation presented with a two-week history of epigastric pain, nausea and vomiting. She had a distended abdomen consistent with a full term gravid uterus; tender at the epigastric and right hypochondrium suggestive of small bowel obstruction or acute appendicitis. Abdominal ultrasound was inconclusive but abdominal Computed Tomography (CT) suggested small bowel volvulus. An exploratory laparotomy revealed a segmental jejunal volvulus and small bowel diverticulum contributing to the volvulus. A short segmental bowel resection was performed. Histopathology confirmed a Meckel's Diverticulum. The patient recovered well but underwent premature labour 10 days later. Small bowel obstruction secondary to Meckel's diverticulum is rare in pregnancy. In an acute gestational abdomen, clinical examination is key. Radiological imaging may be helpful, whilst surgical intervention is confirmatory and therapeutic in the event of an obstructive volvulus.
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PMID:Pregnant and severe acute abdominal pain: A surgical diagnostic dilemma. 2615 17

A 26-year-old woman was referred to our hospital because of abdominal distention and vomiting. Contrast-enhanced computed tomography showed a blind loop of the bowel extending to near the uterus and a fibrotic band connecting the mesentery to the top of the bowel, suggestive of Meckel's diverticulum (MD) and a mesodiverticular band (MDB). After intestinal decompression, elective laparoscopic surgery was carried out. Using three 5-mm ports, MD was dissected from the surrounding adhesion and MDB was divided intracorporeally. And subsequent Meckel's diverticulectomy was performed. The presence of heterotopic gastric mucosa was confirmed histologically. The patient had an uneventful postoperative course and was discharged 5 d after the operation. She has remained healthy and symptom-free during 4 years of follow-up. This was considered to be an unusual case of preoperatively diagnosed and laparoscopically treated small-bowel obstruction due to MD in a young adult woman.
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PMID:Laparoscopic surgery for small-bowel obstruction caused by Meckel's diverticulum. 2698 Nov 91