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PubMed1998

[Diagnosis of Meckel diverticulum, containing ectopic gastric mucosa", by studying small bowel passage].

Radiological diagnosis of Meckel diverticulum is a difficult task. Here we report a patient with hereditary sphaerocytosis who complained of a chronic periumbilical pain and in whom antegrade barium enema suggested Meckel diverticulum. The diagnosis had been proven both surgically and histologically. This observation indicates that so called traditional x-ray still has its role even in the era of modern (and expensive) radiology.

Adult↗
PubMed1993

Plain film identification of inverted Meckel diverticulum.

Inversion is a potentially serious complication of Meckel diverticulum. Since inversion provokes gangrene and small bowel obstruction, diagnosis by enteroclysis or imaging studies can conflict with the need for timely surgical intervention. We have noted that plain films may predict this lesion when a solitary mottled polypoid lesion occupies the ileum at the site of a small bowel obstruction.

Child, Preschool↗
PubMed2006

Bleeding Meckel diverticulum associated with a vitellointestinal artery aneurysm found on preoperative angiography: report of a case.

An 18-year-old man was admitted to a local hospital with abdominal pain and bloody stool. Upper and lower gastrointestinal endoscopy failed to show any bleeding sites; however, an angiography of the superior mesenteric artery done on hospital day 4 showed an abnormal artery with an aneurysm, branching from the ileal artery. This artery was thought to be the vitellointestinal artery, a feeding artery of Meckel diverticulum. After embolization, he was transferred to our hospital, where we performed emergency laparotomy with partial resection of the ileum, including a bleeding Meckel diverticulum. Pathological examination revealed ectopic gastric mucosa and peptic ulceration, which we assumed was the origin of the bleeding. The patient had an uneventful postoperative course. Visceral artery aneurysms are rare but important vascular lesions because of their potential for fatal rupture. Although a minimally invasive procedure can be performed for a vitellointestinal artery aneurysm in patients with asymptomatic Meckel diverticulum, we treated our patient surgically because he presented with hemorrhagic shock and had been unresponsive to an H(2)-receptor antagonist.

Adolescent↗
PubMed1998

The value of sonography, CT and air enema for detection of complicated Meckel diverticulum in children with nonspecific clinical presentation.

BACKGROUND: Complicated Meckel diverticulum (MD) in children does not always present with painless rectal bleeding and its presentation can then produce a difficult diagnostic dilemma. In this clinical setting, sonography (US), CT or even air enema may be the first modality chosen to evaluate these children rather than the radionuclide Meckel scan (RNMS). PURPOSE: To assess the value of US, CT and air enema for detection of complicated MD. MATERIALS AND METHODS: Review of clinical, imaging, surgical and pathological findings in 64 children (55 males, 9 females) aged 4 days -14 years (mean = 3.7 years) with MD seen during an 8-year period, 1990-1997. RESULTS: (a) In 33 patients with rectal bleeding, MD was detected on RNMS in 32. Ten of these 32 had other imaging studies, all of which were negative. (b) The other 31 patients, with varied clinical presentations, did not undergo RNMS. In these 31 and the 1 with a negative RNMS, 14 (44 %) had imaging features highly suggestive for the diagnosis of MD on US in all 14, on CT in 1, and on air enema in 3. The radiological spectrum of the inflamed, hemorrhagic MD is illustrated. CONCLUSION: The inflamed, hemorrhagic and the inverted, intussuscepted MD have a spectrum of features recognizable on US, CT and air enema. Some of these appearances are specific, others are not. Knowledge of and recognition of these features will facilitate detection of complicated MD in larger numbers of children presenting with symptoms other than the classic history of painless rectal bleeding and also in those with normal RNMS.

Adolescent↗
PubMed1988

Meckel's diverticulum.

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."

Adolescent↗
PubMed2004

Ranitidine-enhanced 99mtechnetium pertechnetate imaging in children improves the sensitivity of identifying heterotopic gastric mucosa in Meckel's diverticulum.

Meckel's diverticulum is the most common congenital gastrointestinal anomaly. (99m )Technetium pertechnetate imaging (Meckel's scan) is the best noninvasive method used to diagnose this condition when heterotopic gastric mucosa (HGM) is present. Although cimetidine enhancement has been shown to improve sensitivity of the Meckel's scan, ranitidine enhancement has also been advocated; however, this recommendation is based on unpublished data. Thirty-seven children with confirmed Meckel's diverticulum were reviewed retrospectively. Of eight children with HGM in the Meckel's diverticulum who presented with profuse rectal bleeding and underwent the conventional Meckel's scan, three of them (37.5%) had a false negative study. Ranitidine, when administered either intravenously or orally for 24 h prior to the Meckel's scan, enhanced the sensitivity of this test to 87.5% in our patient cohort.

Adolescent↗
PubMed2004

Migrating calcified enterolith and chronic anemia: an unusual case presentation of a Meckel's diverticulum.

Meckel's diverticulum is the most common congenital anomaly of the small intestine, occurring in about 2 % of the population. The most common complications associated with a Meckel's diverticulum include obstruction, bleeding, and inflammation (7, 9, 11, 18-20). The estimated lifetime risk of developing symptoms with a Meckel's diverticulum is 4-6 % (16), with the risks of complications decreasing with age. Stones within Meckel's diverticulum are recognized as a rare complication in the adult population (13,15). However, it has not been reported in the pediatric age group. The authors describe a 19-month-old male who presented with intermittent abdominal pain and vomiting, chronic microcytic anemia and a calcified stone in the lower abdomen, who was found to have a Meckel's enterolith.

Anemia↗
PubMedDate not supplied

CT diagnosis of Meckel diverticulum in a paracolic internal hernia.

The autopsy incidence of internal hernia has been reported to be between 0.2% and 0.9%, and these hernias are usually diagnosed on imaging due to their complications or at surgery. Meckel diverticulum is the most common congenital anomaly of the gastrointestinal tract, occurring in 1% to 3% of the population according to autopsy studies. The condition also is usually diagnosed at surgery, by barium studies or scintigraphy, or on cross-sectional imaging due to complications. We present an unusual case of a large Meckel diverticulum in a right paracolic hernia diagnosed on multidetector computed tomography. This diagnosis was made after attacks of subacute intestinal obstruction with the aid of multiplanar reconstructions. This case emphasizes the role of multidetector computed tomography and postprocessing techniques such as multiplanar reconstruction in the diagnosis of bowel pathology.

Adult↗
PubMedDate not supplied

Case report. Small bowel obstruction due to phytobezoar formation within Meckel diverticulum: CT findings.

Intestinal obstruction due to a phytobezoar within a Meckel diverticulum is exceedingly rare, with only seven reported cases in the surgical literature. The most important precipitating factor is the ingestion of agents high in fiber and cellulose. Small bowel obstruction in all but one case was due to retrograde propagation of the bezoar into the small bowel lumen. We report the clinical and CT findings in such a patient following a vegetarian diet.

Bezoars↗
PubMed1997

Sonographic appearances of inverted Meckel diverticulum with intussusception.

This study illustrates the sonographic findings of inverted Meckel diverticulum acting as a lead point of an intussusception in five patients. In four patients, the inverted diverticulum was seen as a segment of blind-ending, thick-walled bowel projecting for a variable distance from the apex of the intussusceptum. The larger diverticula had a characteristic bulbous shape. The central serosal surface of the inverted diverticulum was filled with fluid in one patient, with fluid and fat in another, and with echogenic fat only in the other two. The presence of fat was confirmed by CT in one patient. The features illustrated in these four patients appear to be specific. In the fifth patient, the sonogram revealed a nonspecific echogenic mass at the apex of the intussusceptum. Recognition of these features on sonography may obviate the need for further investigation.

Child↗
PubMed2004

Spontaneous haemoperitoneum secondary to a Meckel's diverticulum.

Meckel's diverticulum is a relatively common gastrointestinal entity which occasionally causes complications. Meckel's diverticulum is classically described to mimic acute appendicitis when inflamed as well as being a cause of unexplained luminal gastrointestinal bleeding. An unusual cause of spontaneous non traumatic haemoperitoneum found during surgery performed for a suspected acute appendicitis in a 22-year old female is described. The patient was found to have a significant haemoperitoneum due to a bleeding serosal vessel of a Meckel's diverticulum. The diverticulum was routinely excised. It was macroscopically and histologically devoid of inflammation. The bleeding vessel was not found to be abnormal or part of an arteriovenous malformation.

Adult↗
PubMed1986

Radiology of Meckel's diverticulum.

Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract. Approximately 2 to 3% of all individuals have a Meckel's diverticulum and one third of them experience clinical symptoms. Until a decade ago, the correct diagnosis of the lesion was rarely established prior to abdominal surgery or autopsy. However, the introduction of modern imaging techniques and the refinement of gastrointestinal contrast studies have facilitated the preoperative recognition of this entity. This article reviews the radiographic pathology of Meckel's diverticulum and the spectrum of its associated complications.

Adult↗
PubMed2001

Synchronous gastric adenocarcinomas in a patient with Meckel's diverticulum.

Meckel's diverticulum, which is the most common congenital anomaly of the gastrointestinal tract, occurs when the vitelline duct persists past the 7th week of gestation. Although complications may occur in 8% to 22% of patients with Meckel's diverticula, adenocarcinoma is very uncommon. We describe a patient with early gastric cancer who was incidentally found to have a superficial adenocarcinoma arising from ectopic gastric mucosa within a Meckel's diverticulum. To the best of our knowledge, synchronous gastric adenocarcinoma in a patient with Meckel's diverticulum has not been previously reported.

Adenocarcinoma↗
PubMed1994

Laparoscopic diagnosis and excision of Meckel's diverticulum.

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.

Adolescent↗
PubMed1986

Malignant melanoma in Meckel's diverticulum.

Meckel's diverticulum is a vestigial remnant of the omphalomesenteric duct, which is rarely affected by neoplasia. The authors report the first case of malignant melanoma in Meckel's diverticulum in a middle-aged man without skin or ocular lesions. Five other Meckel's diverticuli were evaluated histologically and by immunoperoxidase technics for neural crest elements, which could have given rise to this lesion.

Humans↗