Giant Meckel's Diverticulum in a Premature Infant

Cross, Valmore F.; Wendth, Arthur J.; Phelan, John J.; Goussous, Haider; Moriarty, Daniel J.

doi:10.2214/ajr.108.3.591

Cited by 17 publications

(7 citation statements)

References 18 publications

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“…In the neonate, several reported cases of complicated Meckel's diverticulum have been misdiagnosed as meconium ileus because of a large area of air mixed with granular bowel contents on plain film. 15,16 Interestingly, our diverticulum was large enough to be seen on plain film taken 13 h after birth. Thereafter, the operative findings were proof that the dilated bowel loop was Meckel's diverticulum.…”

Section: Discussionmentioning

confidence: 85%

Spontaneous Perforation of Meckel's Diverticulum Without Peritonitis in a Newborn: Report of a Case

2006

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A case of a newborn male with a perforation of Meckel's diverticulum is reported. The clinical course consisted of progressive abdominal distention and pneumoperitoneum that formed within 29 h after birth. The perforation of Meckel's diverticulum was not associated with peritonitis because meconium did not contaminate the abdominal cavity. The histology of the diverticulum showed a nearly intact muscular layer but a focal muscular defect. Neither any inflammatory phenomena nor ectopic mucosa was found. A congenital focal muscular defect of the diverticulum and a sudden elevation of intraluminal pressure due to bowel movement after birth may thus be the pathogenesis of a spontaneous perforation. A search of the English literature did not reveal any similar case.

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Section: Discussionmentioning

confidence: 85%

Spontaneous Perforation of Meckel's Diverticulum Without Peritonitis in a Newborn: Report of a Case

2006

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“…It was shown that the ratio of complications correlates with the size of the diverticulum (7). Giant diverticula occur in two relatively distinct forms: the elongated type and the ovoid or saccular type (8). The elongated type is the more common type and is characterized by the same caliber as the ileum (8).…”

Section: Discussionmentioning

confidence: 99%

“…Giant diverticula occur in two relatively distinct forms: the elongated type and the ovoid or saccular type (8). The elongated type is the more common type and is characterized by the same caliber as the ileum (8). This type can cause intestinal obstruction due to knotting around the small bowel (2).…”

Section: Discussionmentioning

confidence: 99%

Twisting of a Giant Cystic Meckel’s Diverticulum in a Toddler: A Case Report and Brief Literature Review

Zvizdić

2022

Central Eur J Paed

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Objective: Herein we report an unusual case of torsed giant cystic Meckel's diverticulum (MD) in a three-year-old boy, illustrating the rarity of this condition and briefly reviewing the literature on it. Case Report: A three-year-old boy who clinically presented with severe colicky abdominal pain and frequent vomiting. Abdominal ultrasonography showed a cystic lesion in the lower abdomen. Contrast-enhanced CT revealed a well-defined right upper quadrant cystic mass measuring ~5 × 4 cm. The cystic mass appeared to be arising from the small intestine. The radiological features were not suggestive of malignancy. An urgent laparotomy was performed. At operation, he was found to have an incomplete torsed giant cystic MD. Postoperative recovery was uneventful, and the patient was discharged on the sixth postoperative day. A regular, 3-year follow-up revealed no complications. Conclusion: A giant cystic Meckel's diverticulum represents a rare cause of intra-abdominal/pelvic mass and should be considered in its differential diagnosis. Timely surgical intervention reduces morbidity and provides the best clinical outcome.

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“…Some authors reserve the term 'giant' for type 2 diverticula. 3 Giant Meckel's diverticulum presents most commonly with obstruction (volvulus, intussusception or internal herniation in neonates or mass effect and adhesions in adults). 4 A type 1 giant Meckel's diverticulum can cause obstruction by wrapping around the small bowel.…”

Section: Giant Meckel's Diverticulummentioning

confidence: 99%

The trouble with investigating anaemia in young adults: bleeding from a giant Meckel's diverticulum without ectopic gastric mucosa

Tang

Zaidi²

2009

Ann R Coll Surg Engl

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A 21-year-old man collapsed with anaemia (haemoglobin < 6 g/dl). He underwent immediate oesophagogastroduodenoscopy and colonoscopy which were both normal. The bleeding stopped spontaneously and, following a blood transfusion, he made a rapid recovery. His repeat blood tests showed a haemoglobin of 11.6 g/dl, mean corpuscular volume (MCV) 74 fl, platelet count 398 x 10 9 /l, ferritin 37 ng/ml and normal clotting. A barium study demonstrated a large saccular viscus in the pelvis containing food debris but it was not possible to determine whether these areas were diverticula or saccular parts of the bowel. A computed tomography (CT) scan of the abdomen revealed a large gas and debris-filled structure in the pelvis. Again, it was not possible to determine from which loop of bowel it arose but there was the suggestion of a vitelline artery supplying it. An isotope Meckel's scan using 99m-technetium pertechnatate was performed and this showed normal uptake by the gastric mucosa and normal passage of tracer distally from the stomach. However, there was no uptake seen in right iliac fossa to suggest a Meckel's diverticulum. The area that corresponded to the abnormal viscus was represented by a photopaenic area with no isotope activity within it.Soon after, he was admitted to hospital as an emergency with massive rectal haemorrhage. He underwent laparotomy when a giant Meckel's diverticulum was found. The middle of the diverticulum measured 8 cm in diameter and, on slicing, revealed the presence of a large blood clotThe trouble with investigating anaemia in young adults: bleeding from a giant Meckel's diverticulum without ectopic gastric mucosa S TANG, A ZAIDI Department of Surgery, St Helier Hospital, Carshalton, Surrey, UKABSTRACT Giant Meckel's diverticulum is rare and usually presents in childhood with haemorrhage or bowel obstruction. Bleeding results from the presence of ectopic gastric mucosa causing peptic ulceration of adjacent mucosa. We discuss the case of a 21-year-old man with a giant Meckel's diverticulum who presented with rectal bleeding. A Meckel's scan was negative and histology following surgical excision ruled out the presence of ectopic gastric mucosa. There was however evidence of chronic inflammation and small bowel mucosal ulceration. We hypothesize that this arose from ischaemia and pressure necrosis because of the large size of the diverticulum and chronic distension by food debris. This case highlights the difficulties in investigating anaemia in young adults despite modern imaging techniques.

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Giant Meckel's Diverticulum in a Premature Infant

Cited by 17 publications

References 18 publications

Spontaneous Perforation of Meckel's Diverticulum Without Peritonitis in a Newborn: Report of a Case

Spontaneous Perforation of Meckel's Diverticulum Without Peritonitis in a Newborn: Report of a Case

Twisting of a Giant Cystic Meckel’s Diverticulum in a Toddler: A Case Report and Brief Literature Review

The trouble with investigating anaemia in young adults: bleeding from a giant Meckel's diverticulum without ectopic gastric mucosa

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