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

The patient with acquired immune deficiency syndrome (AIDS) and abdominal pain presents the surgeon with a difficult challenge. The pain may be due to an opportunistic infection, ileus, organomegaly, or a true surgical emergency. The hospital records of 235 patients with AIDS were reviewed. Of the 29 patients with abdominal pain, 12 had infectious diarrhea, eight were diagnosed as having ileus or organomegaly, and nine had miscellaneous causes for their pain. Only five patients underwent laparotomy. Two patients were operated on for pain associated with bleeding (Meckel's diverticulum and intestinal Kaposi's sarcoma); one had a perforated duodenal ulcer and one had severe ileitis. One patient was electively operated on for Burkitt's lymphoma. Laparotomy for abdominal pain is not usually necessary in patients with AIDS. Specific recommendations for evaluation and management of these patients are offered.
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PMID:Abdominal pain in patients with acquired immune deficiency syndrome. 378 34

Calculus formation is a rare complication of a Meckel's diverticulum. These calculi may cause a mechanical small-bowel obstruction--Meckel stone ileus--an extremely rare mode of presentation of a Meckel's diverticulum. A case in which this has occurred is reported--only the fifth such occasion that this has happened.
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PMID:Meckel stone ileus: a case report. 693 30

The analysis of 382 observations of the complicated Meckel's diverticulum in children and adults is presented. The clinical course of the diverticulum, ileus resulting from this defect, peptic ulcer of the diverticulum are described. It has been established that in people having the diverticulum there occur other congenital developmental abnormalities which may be used for making the diagnosis of the disease.
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PMID:[Diagnostic principles in complications of Meckel's diverticulum]. 731

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

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

Volvulus of the small intestine is a condition of bowel obstruction due to knotting and twisting of the small intestine. Two types of volvulus are described: 1) primary small intestinal volvulus where no predisposing factors exist, and 2) secondary volvulus where congenital or acquired conditions promote twisting of the small intestine. Over a 5-year period, 18 patients (eleven men and seven women) presenting volvulus of the small intestine are operated in the Emergency Surgery Clinic of the University Hospital "Queen Giovanna", representing 8.7 per cent of the total of 206 cases of small intestinal mechanical ileus (incarcerated herniations involving the small intestine are not included in the series). Primary volvulus is found in one patient. In those presenting secondary volvulus adhesions are the commonest underlying cause of small intestinal rotation--13 cases, next ranking primary tumor of the small intestine--one case, Meckel's diverticulum--one, carcinosis of peritoneum--one, and one patient with small intestine volvulation around colostomy. The most frequently encountered symptoms and laboratory examinations performed are analyzed. Intestinal necrosis is established in four instances (22 per cent). One patient dies of peritonitis and polyorganic insufficiency. Volvulus of the small intestine should be mandatorily considered in patients presenting mechanical ileus of the small intestine. Early operative intervention is a therapeutic approach contributing to preclude intestinal necrosis.
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PMID:[Volvulus of the small intestine]. 973 71

Over a period of 10 years, five children developed postoperative intussusception after intra-abdominal procedures at the Department of Pediatric Surgery of the Johannes Gutenberg University Mainz. Two appendectomies, one ileal resection for a Meckel's diverticulum, one operative procedure for Hirschsprung's disease plus intestinal neuronal dysplasia type B, and one hiatoplasty with jejunostomy preceded the intussusception. Three of the five children were older than 2 years. The clinical symptoms consisted primarily of abdominal distension, diffuse abdominal pain, bilious vomiting, and rectal bleeding in one case. Preoperative diagnosis was achieved in four cases by abdominal ultrasound. Plain abdominal radiographs demonstrated dilated loops of small intestine with air-fluid levels in four of the five cases. In the case without radiographic findings, the jejunojejunal intussusception was missed even by a bowel follow-through. The intussusceptions were ileocolic (3), ileoileal (1), and jejunojejunal (1). A hydrostatic procedure to reduce an ileocolic intussusception was not successful. Operative treatment of the intussusception was performed in three cases within 5 days, once at 32 days, and once 3 months after the primary operation, in all cases by laparatomy and simple manual reduction without intestinal resection. In contrast to idiopathic intussusception, noninvasive hydrostatic procedures are not indicated in postoperative intussusception, since protection of intestinal anastomoses from hydrostatic pressure and exclusion of other causes of postoperative ileus are mandatory.
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PMID:Postoperative intussusception in childhood. 988 Jul 41

We report a case of gallstone ileus in which the stone impacted at the neck of a Meckel's diverticulum. CT demonstrated the gallstone as a calcified mass in the lower abdomen. Gallstone ileus was diagnosed although a more accurate diagnosis was not obtained pre-operatively. The site of impaction was not typical and a blind loop filled with contrast materials was evident. We believe that this is the first report demonstrating this rare condition with imaging.
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PMID:Gallstone ileus with impaction at the neck of a Meckel's diverticulum. 1031 10

The authors performed a retrospective analysis of 108 operations performed because of Meckel's diverticulum from Jan. 1, 1980 until Dec. 31, 1997. 87 incidental operations were performed (80.55%) and 21 operations were performed (19.54%) because of complications of Meckel's diverticulum. Of the 87 incidental cases, 44 were males and 43 were females. The diverticulum was resected in 70 cases, was inverted in 16 patients and was left untouched in 1 patient. There were postoperative complications in 10 cases (11.5%), however, only one complication was related to the diverticulum operation. There was one death due to pneumonia in the incidental group (1.14%). Of the 21 cases having complications there were 5 females and 16 males. The following complications were observed: 4 cases of ileus, 7 cases of perforation (a foreign body was found in two cases) and 10 cases of inflammation. The Meckel's diverticulum was resected in 19 cases and the small intestine was resected in 2 cases. Postoperative complications occurred in 3 cases (14.3%), however these were not related to the diverticulum operations. There were 2 deaths due to pneumonia and pulmonary embolism (9.5%). Histological examination revealed 7 cases of heterotopic gastric mucosa in both the incidental group and the group with complications. There was one case of heterotopic pancreatic tissue in the group with complications. The incidence of heterotopy in the incidental group was 8%, whereas in the group with complications the incidence was 33.3%. Histological examination also revealed reflux gastritis-like diverticulitis in 5 of the patients with heterotopic gastric mucosa. Meckel's diverticulum was diagnosed in 2 patients preoperatively by upper gastrointestinal series.
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PMID:[Meckel diverticulum as a possible source of complications]. 1053 81

Intussusception occurs commonly in children, but rarely is observed in adults. Whereas the hydrostatic pressure of a contrast enema often proves diagnostic as well as therapeutic in infants and children, resection usually is required for an underlying bowel pathology in older children and adults. Conventionally, the resection is accomplished at laparotomy. We report the case of a 20-year-old woman who presented with diarrhea and vomiting of 1 week duration. She was found unexpectedly to have intussusception on abdominal ultrasonography. The intussusception was laparoscopically reduced, and a segment of the middle small bowel that harbored an inverted Meckel's diverticulum was resected laparoscopically, after which an intracorporeal anastomosis was fashioned. The ileus resolved on postoperative day 4, and the patient was discharged from hospital on postoperative day 5. The role of the laparoscopic approach in the management of intussusception is discussed.
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PMID:Laparoscopic reduction of an ileoileal intussusception and resection of an inverted Meckel's diverticulum in an adult. 1272 89


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