Meckel's Diverticulum: a Systematic Review

Abstract

Meckel's diverticulum is the most common congenital malformation of gastrointestinal tract. It can cause complications in the form of ulceration, haemorrhage, intussusception, intestinal obstruction, perforation and, very rarely, vesicodiverticular fistulae and tumours. These complications, especially bleeding, are more common in the paediatric age group than in adults; however it is not uncommon to miss the diagnosis of Meckel's diverticulum in adults. Here, we reviewed the literature regarding the complications of this forgotten clinical entity in adults with potential diagnostic difficulties and management strategies.

Steroid Induced Perforation of Meckel's Diverticulum in an Adult

“…The perforations can be NSAID induced [5], fish or chicken bone impaction [6,7]. Steroid induced peptic perforation is a documented complications of long standing systemic steroid therapy [8,9]. Our patient was on oral prednisolone therapy for psoriasis 20 mg per day for last four months.…”

“…Meckel's diverticulum and its complications especially perforation can be an elusive diagnosis, particularly in the adult patient [8]. Very few cases of perforated Meckel's diverticula in adults are diagnosed preoperatively by standard abdominal imaging studies such as CT scan and ultrasonography because of presence of air pockets, free fluids and bowel wall edema.…”

“…Despite the previously mentioned modalities, most complicated Meckel's diverticula are still identified at the time of abdominal exploration. The technetium-99m pertechnate scan, or Meckel's scan, is generally regarded as the most accurate, non-invasive diagnostic technique [4,8]. However in emergency situations when a diagnosis of perforative peritonitis is well established one should go for diagnostic laparoscopy or exploratory laparotomy [12,13].…”

Multiple jejunal diverticulitis presenting with acute intestinal obstruction: a diagnostic dilemma

“…4,5 This explains their typical location at the mesenteric side. 1,4,6 Diverticula are more frequent in jejunum (61%) than the other parts of the small bowel and it is attributed to the greater diameter of the penetrating jejunal artery. 5 Coexistent diverticuli are found in many other digestive localization.…”

“…1 They are a diagnostic headache as well as a therapeutic challenge to surgeons throughout the world. These diverticuli mostly multiple in the jejunum and solitary distally and are characteristically found in 60 or 70 year old males.…”