Meckel's diverticulum: new solutions for an old problem?
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ABSTRACT:
SUBMITTER: Chauhan A
PROVIDER: S-EPMC5369507 | biostudies-other | 2016 Apr
REPOSITORIES: biostudies-other
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Project description:The current work attempts to highlight the various life threatening complications of Meckel's diverticulum and to present the surgical strategies used in the emergency conditions so far in the form of a review of the works presented in the literature. Our aim behind this presentation is to cover the possible indications, methods, their complications and the outcome of these surgical techniques. For this, we made an extensive literature search using Google and Pubmed with the words-"Meckel's diverticulum", "Complications", "Management" and "Emergency surgery". All the relevant articles containing the surgical aspects of symptomatic Meckel's diverticulum till May 2008 were collected and analyzed. Meckel's diverticulum is the remains of the prenatal yolkstalk (Vitellointestinal duct). Although it generally remains silent but life threatening complications may arise making it an important structure for having a detailed knowledge of its anatomical and pathophysiological properties to deal with such complications.
| S-EPMC2533303 | biostudies-literature
Project description:Twenty five cases of Meckel's diverticulum were studied between 1985-1995. Eight of these were symptomatic and in the remaining 17 it was an incidental finding. The symptomatic patients presented with intestinal obstruction (5 cases), perforated peritonitis (2 cases) and intussusception (1 case). All cases of acute appendicitis were also subjected to a search for Meckel's diverticulum. Of the 25 Meckel's diverticuli encountered, 22 were resected and in 3 patients it was left in situ. Both the patients with perforated Meckel's diverticulum showed ectopic gastric mucosa. Complications occurred only after surgery for symptomatic Meckel's diverticulum. All patients undergoing incidental diverticulectomy had a smooth and uncomplicated recovery.
| S-EPMC5530974 | biostudies-other
Project description:Introductionand importance: Intussusception is one of the most common causes of acute abdomen and surgical morbidities in the childhood. In a paediatric presentation of intussusception due to Meckel's diverticulum there may be acute onset of abdominal pain, vomiting or painless red currant stools. However, Lethargy has been described as a rare presenting symptom.Case presentationWe present a case of 2,5 - year old female complained of acute alternation in consciousness followed by continuous vomiting two days later.Clinical discussionHer neurological examination showed a lethargic child, not reactive and hypotonic. Her past medical history was unremarkable. Abdominal ultrasonography was compatible with ileocolic intussusception. The necrotic bowel and diverticulum were resected, followed by anastomosis of the viable bowel segments. postoperatively the infant recovered dramatically.ConclusionAlthough lethargy is a rare presenting symptom of Intussusception, it should be kept as a differential diagnosis when a child presents with acute onset of drowsiness with or without abdominal symptoms.
| S-EPMC8329513 | biostudies-literature
Project description:Meckel's diverticulum is a remnant of the omphalomesenteric duct, found only in approximately 2% of the population. Although Meckel's diverticulum is often diagnosed in nonsymptomatic patients as incidental radiologic findings, complications of Meckel's diverticulum can also be seen on radiologic evaluation. We present a rare care of perforated Meckel's diverticulum in a geriatric patient demonstrated on contrast computed tomography. This was later confirmed during laparoscopic surgery with pathologic evaluation.
| S-EPMC7083787 | biostudies-literature
Project description:Introduction and Importance: Meckel's diverticulum band is an uncommon cause of intestinal obstruction in adults. Case presentation We report the case of a 57-year-old diabetic and hypertensive male who presented with sudden onset of vomiting and abdominal pain. Initial laboratory and imaging investigations, including an abdominal X-ray and computed tomography scan, were suggestive of an intestinal obstruction; however, these were not helpful in assigning a presumptive cause. A laparoscopic exploration was offered after a repeated abdominal X-ray showed an air-fluid level. Intraoperative findings revealed an ischemic closed loop obstructed by a fibrous band of Meckel's diverticulum. Resection and anastomosis of the bowel was performed, and the patient was discharged on day 3 post-operative with no complications. Clinical discussion Surgical resection performed by open or laparoscopic approach is the recommended treatment for patients with symptomatic Meckel's diverticulum. Generally, a wedge resection of the Meckel's diverticulum is performed, and occasionally part of the ileum is resected by end-to-end anastomosis, as was the case in our patient. Conclusion We believe early surgical intervention is crucial for a favorable outcome. Thus, surgeons should consider complicated Meckel's diverticulum in patients presenting with signs and symptoms of small bowel obstruction. Highlights • Intestinal Obstruction Caused by Meckel's Diverticulum Band are extremely rare in adult.• Obstruction Caused by Meckel's Diverticulum Band may present a challenging clinical diagnosis.• Surgical resection remains the treatment of choice and plays a potentially curative role.
| S-EPMC9207010 | biostudies-literature
Project description:A 38-year-old female presented to the emergency department (ED) with acute-onset right lower quadrant abdominal pain following two days of nausea and vomiting. Physical examination revealed right lower quadrant tenderness to palpation, rebound tenderness, and guarding. Point-of-care ultrasound (POCUS) of the right lower abdomen was performed and interpreted as probable appendicitis. However, upon laparoscopic examination of the abdomen, a benign-appearing appendix was visualized. Further investigation revealed the source of the patient's pain to be a torsed Meckel's diverticulum. Although rare, a torsed and inflamed Meckel's diverticulum can be visualized by POCUS in the ED without the need for further imaging or delay.
| S-EPMC6682254 | biostudies-literature
Project description:Mitral annular calcification (MAC) is a chronic process involving mitral valve annulus, linked with an increased cardiovascular mortality and morbidity. Since its first autoptic description, a progressive evolution in diagnostic tools brought cardiac computed tomography (CT) scan to become the gold standard in MAC detection and classification. The treatment of significant mitral valve disease in patients with annular calcifications has always represented an issue for cardiac surgeons, being it linked with an increased risk of atrioventricular groove rupture, circumflex artery injury, or embolism. As a consequence, different surgical techniques have been developed over time in order to reduce the incidence of these fearsome complications. Recently, transcatheter mitral valve replacement (TMVR) has emerged as a valid alternative to surgery in high-risk patients. Both hybrid transatrial, transfemoral, or transapical approaches have been described to deliver balloon-expandable or self-expanding aortic transcatheter valves into the calcified annulus, with conflicting early and long-term results. Tendyne (Abbott Structural Heart, Santa Clara, CA, USA) is a promising transapical-delivered option. Early results have shown effectiveness and safety of this device in patients with MAC and severe mitral valve disease, with the lowest rate of embolization, mortality, and left ventricular outflow tract obstruction (LVOTO) reported so far.
| S-EPMC9719907 | biostudies-literature
Project description:BackgroundSymptomatic Meckel's diverticulum (MD) is easily neglected in the acute abdomen during pregnancy. MD is the most common congenitally anomalous development of the intestines, with an incidence of 2% in the general population, although it is not easily diagnosed because of variable clinical features. Especially when complicated with pregnancy, doctors can easily overlook this disease, which directly threatens maternal and foetal life.Case presentationWe report the case of a 25-year-old at 32 + 2 weeks of gestation complicated with MD volvulus who presented with progressive abdominal pain and finally peritonitis. She underwent exploratory laparotomy and small-bowel resection. The mother and the baby successfully recovered.ConclusionsMD-complicated pregnancy is not easily diagnosed. Once highly suspiciously diagnosed, especially with peritonitis, surgery should be arranged, which helps preserve maternal and foetal life.
| S-EPMC9977996 | biostudies-literature
Project description:Complicated Meckel's diverticulum represents a common etiology of acute abdomen in children. However, this condition is less frequent in adults. We reviewed the records of adult patients who underwent the surgical removal of complicated Meckel's diverticulum between 2001 and 2017 at 2 tertiary French medical centers. We then analyzed the clinical characteristics, mode of presentation, and management for all patients.The Meckel's diverticulum was resected in 37 patients (24 males and 13 females). The mean patient age was 46.1?±?21.4 years. The most common clinical presentations of complicated Meckel's diverticulum were diverticulitis (35.1%, n?=?13), small-bowel obstruction (35.1%, n?=?13), and gastrointestinal bleeding (29.8%, n?=?11) (anemia, n?=?1; hematochezia, n?=?10). Age distribution was significantly different (P?=?.02) according to the 3 Meckel's diverticulum complications: patients with diverticulitis (P?=?.02) were statistically more frequently over 40 (P?=?.05), significantly older than patients with gastrointestinal bleeding who were more frequently <40 (P?=?.05). There was a preoperative diagnosis available for 15 of the 37 patients (40%). An exploratory laparoscopy was necessary to determine the cause of disease for the other 22 patients (60%). An intestinal resection was performed in 33 patients (89%) and diverticulectomy was performed in 4 patients (11%). There was heterotopic tissue found in only 6 patients (16%). Postoperative complications were as follows: 1 death by cardiac failure in a 92-year-old patient and 2 patients with postoperative wound infections. The follow-up time was 3 to 12 months.The correct diagnosis of complicated Meckel's diverticulum in adults is difficult due to the lack of specific clinical presentation. As a result, exploratory laparoscopy appears to play a central role in cases of acute abdomen with uncertain diagnosis.
| S-EPMC6160168 | biostudies-other
Project description:Radiation therapy is a major treatment modality for management of non-small cell lung cancer. Radiation pneumonitis is a dose limiting toxicity of radiotherapy, affecting its therapeutic ratio. This review presents patient and treatment related factors associated with the development of radiation pneumonitis. Research focusing on reducing the incidence of radiation pneumonitis by using information about lung ventilation, imaging-based biomarkers as well as normal tissue complication models is discussed. Recent advances in our understanding of molecular mechanisms underlying lung injury has led to the development of several targeted interventions, which are also explored in this review.
| S-EPMC6071030 | biostudies-literature