Laparoscopic Resection of an Axially Torted Meckel’s Diverticulum in a 13-Year-Old

Prasad, T. R. Sai; Chui, Chan Hon; Jacobsen, Anette Sundfor

doi:10.1089/lap.2006.16.425

Cited by 12 publications

(16 citation statements)

References 9 publications

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“…The advent of laparoscopy and its safe application in children over the past decade has opened new avenues in the diagnosis and management of complicated as well as incidental MD [3][4][5][7][8][9][10][11][12][13][14][15][16][17]. Our case series illustrates the utility of laparoscopic assistance in the management of varied complications associated with MD.…”

Section: Introductionmentioning

confidence: 99%

Meckel’s diverticular complications in children: is laparoscopy the order of the day?

et al. 2006

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Meckel's diverticulum (MD), a seemingly innocuous anomaly of the gastrointestinal tract, presents distinctive challenges to a clinician, as it is prone to varied complications that are frequently elusive to diagnosis with conventional diagnostic modalities. This case series illustrates the diverse presentations and advantages of laparoscopic-assisted management of Meckel's diverticular complications in children. Between October 2002 and April 2006, 36 patients (27 males and 9 females) aged 1.5 to 16 years (median 10 years) underwent laparoscopic-assisted trans-umbilical Meckel's diverticulectomy (LATUM). Sixteen (44.4%) patients presented with lower gastrointestinal bleeding (14 with painless bleed and 2 with perforated peptic ulcer in the ileum adjacent to the MD), six (16.7%) patients presented with intestinal obstruction (four due to a mesodiverticular band and one each due to intussusception and floppy giant cystic dilatation of MD causing intestinal compression) and four (11.1%) patients presented with features masquerading as appendicitis (one with Meckel's diverticulitis and perforation, one with perforated peptic ulcer adjacent to MD and two with a torted and gangrenous MD). In ten (27.8%) patients, incidental MD with a narrow base was noted at laparoscopic exploration for suspected appendicitis. All patients underwent successful LATUM along with appendicectomy in 15 (41.7%) patients. The operative duration ranged from 72 to 266 min (mean 125.9+/-48.4). There were no intra-operative complications and none required conversion to open surgery. The hospital stay was 3 to 9 days (mean 5.3+/-1.2). There were three (8.3%) cases of postoperative adhesive intestinal obstruction; two underwent successful laparoscopic adhesiolysis and one necessitated conversion to suprapubic laparotomy to release the pelvic adhesions. There were no other complications during the follow-up (median 16 months). LATUM is a safe, effective and an esthetic procedure offering timely diagnosis and cure for diverse Meckel's diverticular complications. The technique also allows palpation of the MD and avoids usage of expensive staplers.

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Section: Introductionmentioning

confidence: 99%

Meckel’s diverticular complications in children: is laparoscopy the order of the day?

et al. 2006

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“…[4][5][6][7][8][9] The patients who were diagnosed axial torsion of MD usually presented preoperatively as intestinal obstruction or right lower quadrant pain mimicking the acute appendicitis. And in these patients, the axial torsion occurred the narrow base of MD and the length of torted MD was very long (6~16 cm).…”

Section: Discussionmentioning

confidence: 99%

“…Some authors emphasized that diagnostic laparoscopy could facilitate the accurate diagnosis atypical abdominal pain and prompt treatment of complicated MD. 6,8 And also it may be possible to perform Meckel's diverticulectomy by exteriorization of MD through the extension of umbilical incision 9 or by totally laparoscopic procedure 8 or by conversion to laparotomy after laparoscopic exploration 7 . Relatively longer MD that is more than twice the length of its diameter tends to possess the ectopic gastric or pancreatic mucosa in its tip rather than the base of MD.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Treatment of Gangrene of Giant Meckel’s Diverticulum Secondary to Axial Torsion

Jeong

Kim

2015

J Minim Invasive Surg

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Meckel's diverticulum is a common congenital anomaly in the small bowel. Most cases of Meckel's diverticulum are asymptomatic and are found incidentally. We herein report on a case of a 21-yearold male patient who complained of lower abdominal pain and febrile sensation with incidentally diagnosed gangrenous change of Meckel's diverticulum due to axial torsion itself. A 21-year-old man presented to our institution with acute lower abdominal pain. No accurate focus on abdominal pain such as appendicitis or diverticulitis was observed on abdominal ultrasonography and abdominal CT scan. However, the physical examination of the patient revealed the symptom of localized peritonitis with fever. Finally, laparoscopic exploration was performed to determine the cause of acute abdominal pain. During the operation, we found gangrenous change of Meckel's diverticulum with axial torsion itself and laparoscopic Meckel's diverticulectomy was performed. The patient made an uneventful recovery and was discharged on the 6 th postoperative day.

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“…For adults, the average distance of the Meckel's diverticulum from the ileocecal valve is 67 cm [9]. Its size is also variable, with the majority being short and wide-mouthed, with a mean length of 2.9 cm and a mean width of 1.9 cm, which is why it is sometimes called an ileal appendix [10]. It is found in about 2% of the population.…”

Section: Discussionmentioning

confidence: 99%

Mesodiverticular Band of Meckel's Diverticulum as a Rare Cause of Small Bowel Obstruction: Case Report and Review of the Literature

et al. 2013

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Background: Meckel's diverticulum, which was first described by Johann Friedrich Meckel, is a congenital anomaly. It results from incomplete obliteration of the most proximal portion of the vitelline or omphalomesenteric duct. Its prevalence is ranging from 1 to 4% of the population. The lifetime risk of complications is estimated at 4-6%. One of them is intestinal obstruction which is a more common presentation among adults. Mesodiverticular band, as presented in this case report, is a rare cause of small bowel obstruction in Meckel's diverticulum. Case Report: We report the case of a 17-year-old male who had intestinal obstruction caused by a mesodiverticular band of Meckel's diverticulum. He presented with severe abdominal pain, nausea, and vomiting. The established diagnosis was mechanical intestinal obstruction. Laparotomy revealed an internal herniation and obstruction caused by a mesodiverticular band of Meckel's diverticulum. There was no evidence of necrosis or ischemia. The mesodiverticular band was released from the ileal mesentery and the Meckel's diverticulum was resected. The postoperative period was uneventful and the patient was discharged after 6 days. Conclusion: The incidence of an internal hernia caused by a mesodiverticular band of Meckel's diverticulum is rare. It may be overlooked in the case of intestinal obstruction because of nonspecific symptoms. Delay in the diagnosis can lead to significant morbidity and mortality. In the case of small bowel obstruction, Meckel's diverticulum should therefore be kept in mind.

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Laparoscopic Resection of an Axially Torted Meckel’s Diverticulum in a 13-Year-Old

Cited by 12 publications

References 9 publications

Meckel’s diverticular complications in children: is laparoscopy the order of the day?

Meckel’s diverticular complications in children: is laparoscopy the order of the day?

Laparoscopic Treatment of Gangrene of Giant Meckel’s Diverticulum Secondary to Axial Torsion

Mesodiverticular Band of Meckel's Diverticulum as a Rare Cause of Small Bowel Obstruction: Case Report and Review of the Literature

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