Meckel’s diverticulum masked by a long period of intermittent recurrent subocclusive episodes

Abstract

Meckel's diverticulum (MD) is the most frequent congenital abnormality of the small bowel and it is often difficult to diagnose. It is usually asymptomatic but approximately 4% are symptomatic with complications such as bleeding, intestinal obstruction, and inflammation. The authors report a case of a 7-year-old boy with a one-year history of recurrent periumbilical colicky pain with associated alimentary vomiting, symptoms erroneously related to a cyclic vomiting syndrome but not to MD. The clinical features and the differential diagnostic methods employed for diagnosis of MD are discussed.

Diagnóstico endoscópico de una invaginación por divertículo de Meckel

“…Puede considerarse la forma más grave de alteración entérica neuromuscular, aunque menos frecuente, que dispepsias funcionales, intestino irritable o vómitos cíclicos 3,4 . Es poco frecuente, pero ocasiona mucha morbilidad, especialmente por la dificultad en el diagnóstico (con una media de retraso de 8 años desde el inicio de los síntomas) 1 y tratamiento.…”

“…El retraso, la dificultad diagnóstica y la variabilidad de su presentación, hacen imposible conocer datos reales de incidencia o prevalencia, pero en estudios de casos parece ser más frecuente en mujeres que se diagnostican alrededor de la cuarta o quinta década tras una década de síntomas 3,6,7 Se suelen considerar 3 criterios diagnósticos en adultos: sospecha diagnóstica, demostración de dilatación de intestino delgado y exclusión de una obstrucción mecánica 3,4 . En los análisis pueden existir datos de malnutrición o malabsorción.…”

Mimicking T- shaped giant meckel's diverticulum: another rare anatomical variant complicating small bowel obstruction by adhesions

“…Symptoms may vary from intermittent recurrent sub occlusive episodes (as in our patient) to frank occlusion with strangulation if complete volvulous occurs. 3 The factors predisposing to intestinal obstruction in the presence of Meckels diverticulum is either its excessive length, narrow base, inflammation, axial torsion, meso diverticular band, intussusceptions, volvulous and enterolith. 4,5 The overall life time risk of complication is 3.7% at the age of 16 years decreasing to zero by 76 years of age.…”

Giant Meckel diverticulum with enteroliths: a case report of a patient presenting with low back and episodic right lower quadrant pain

“…It is www.journalchiromed.com commonly associated with the "rule of 2s": (1) occurs in 2% of the population, (2) measures approximately 2 inches in length, (3) is located within 2 ft of the ileocecal valve, (4) occurs in children younger than 2 years, and (5) is twice as common (to have complications) in males. 5,6 The diverticulum length averages 3 cm, with 90% ranging from 1 to 10 cm and a giant diverticulum being defined as larger than 5 to 6 cm. 2,6,7 This anomaly is asymptomatic in most patients but can become symptomatic if complications arise and mimic common gastrointestinal problems.…”

“…2,6,7 This anomaly is asymptomatic in most patients but can become symptomatic if complications arise and mimic common gastrointestinal problems. 5 Complications occur 20% to 30% of the time and can be associated with life-threatening conditions. 6 Complications occur more frequently in children, with 60% of patients becoming symptomatic before the age of 10 years.…”