Neonatal Meckel diverticulum: Obstruction due to a short mesodiverticular band

Kunitsu, Tomoaki; Koshida, Shigeki; Tanaka, Keiko; Nakahara, Sayuri; Yanagi, Takahide; Maruo, Yoshihiro; Takeuchi, Yoshihiro; Kubota, Yoshihiro

doi:10.1111/ped.12694

Cited by 14 publications

(14 citation statements)

References 5 publications

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“…Many cases of volvulus and intestinal obstruction have been reported (KIM, CHA, LEE et al, 2008;ALTAF and AREF, 2014;BĂLĂLĂU, BACALBAŞA, MOTOFEI et al, 2015). Chances of intestinal obstructions increase when there are peritoneal bands or fibrous bands attaching the diverticulum to various other structures (MCANENY, RAPO and GRINDLINGER, 1989;KUNITSU, KOSHIDA, TANAKA et al, 2015). Intussusception is another complication as reported by many studies (ANWAR, AHMED, AL HINDI et al, 2014;LUBSZCZYK, KALISZEWSKI and STRUTYŃSKA-KARPIŃSKA, 2015;HUNTINGFORD, MONTALTO and CHOUDHRY, 2015).…”

Section: Discussionmentioning

confidence: 95%

Histo-morphological study of a giant Meckel's diverticulum with gastric type of mucosa

et al. 2016

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Introduction: Meckel's diverticulum or ileal diverticulum is one of the common congenital anomalies of the digestive system. It may not cause any problems in many, but may form serious life threatening complications in a few. Materials and Methods: We conducted a histo-morphological study of a giant Meckel's diverticulum found during cadaveric dissections of a South Indian adult male cadaver. The diverticulum was 7.5 cm long and had a circumference of 1.5 cm. Results: Gross anatomical and histological observations revealed healthy nature of the diverticulum without any inflammation. However, the mucosa had gastric type of glands with plenty of parietal cells. This incidence of Meckel's diverticulum was noted in only one cadaver among more than 100 cadavers dissected in the past twenty years. Conclusion: Knowledge of its morphological features may be very useful to surgeons, radiologists and gastroenterologists. We discuss the clinical importance of the diverticulum and review the relevant literature in this manuscript.

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Section: Discussionmentioning

confidence: 95%

Histo-morphological study of a giant Meckel's diverticulum with gastric type of mucosa

et al. 2016

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“…In addition to our 2 cases, the review of the literature showed 8 other cases of symptomatic MDB in pediatric patients (Table 1 ). [ 5 , 12 – 17 ] The age of onset ranged from 10 days to 12 years. All cases reported an intestinal occlusion as the clinical picture at onset.…”

Section: Discussionmentioning

confidence: 99%

“…Kunitsu et al reported that a relatively long MDB can lead to pathogenesis over a wide age range, from childhood to adulthood, with regard to the internal hernia of an intestinal loop. [ 17 ] In contrast, a short MDB can exert direct compression on the digestive tract before or shortly after birth.…”

Section: Discussionmentioning

confidence: 99%

Obstructive internal hernia caused by mesodiverticular bands in children

Bertozzi

Melissa²,

Magrini³

et al. 2017

Medicine

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Introduction:The mesodiverticular band (MDB) is an embryologic remnant of the vitelline circulation, which carries the arterial supply to the Meckel diverticulum. In the event of an error of involution, a patent or nonpatent arterial band persists and extends from the mesentery to the apex of the antimesenteric diverticulum. This creates a snare-like opening through which bowel loops may herniate and become obstructed. This report describes 2 rare cases of small bowel occlusion owing to an internal hernia caused by a MDB.Cases:Case 1 was a 5-year-old boy who presented to our Emergency Department with colicky abdominal pain diffused to all abdominal quadrants. He also had 5 episodes of emesis, the last with bilious vomiting. Case 2, a 12-year-old boy, presented to our Emergency Department complaining of colicky abdominal pain. He had 2 episodes of nonbilious emesis. On physical examination, both children showed distension and tenderness of the abdomen and abdominal x-ray and ultrasound confirmed an occlusive picture without an apparent etiology. In case 1, an urgent laparotomy was performed and the MDB was ligated and cut, whereas in case 2 diagnosis and excision were performed in laparotomy. In both patients, there was a positive clinical evolution.Conclusion:Although MDB causing internal hernia is very rare, it should be considered in patients with a clinical picture of small bowel obstruction. In these cases, early surgery is important to prevent strangulation and gangrene of the bowel and to avoid dramatic events. Moreover, laparoscopy seems a safe and effective technique in these patients, especially in children with mild abdominal distention without surgical or trauma history, highlighting that further studies on the value of laparoscopy for the treatment of small bowel obstruction in pediatric patients are urgently needed.

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“…6 Rarely, direct compression of the small bowel by the mesodiverticular band, rather than an internal hernia, as in our case, may be the cause of small bowel obstruction due to mesodiverticular band, as has been described in a newborn. 2 Other rare complications associated with a mesodiverticular band have included axial torsion of the diverticulum itself due to the band 7 and aneurysmal rupture of a mesodiverticular band artery, with significant peritoneal hemorrhage, 8 both in adults.…”

Section: Discussionmentioning

confidence: 99%

Sudden Death Associated With Incarcerated Small Bowel Due to Mesodiverticular Band

et al. 2017

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Meckel's diverticulum is a congenital anomaly present in about 3% of the population and usually asymptomatic. Rarely, a mesodiverticular band extends from the tip of a Meckel's diverticulum to the mesentery, thought to be due to lack of involution of the left vitelline artery. The presence of this band creates a closed loop through which loops of bowel can become entrapped. Rare case reports have described incarceration of bowel and sudden death in children. We present such a case and discuss this entity.

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Neonatal Meckel diverticulum: Obstruction due to a short mesodiverticular band

Cited by 14 publications

References 5 publications

Histo-morphological study of a giant Meckel's diverticulum with gastric type of mucosa

Histo-morphological study of a giant Meckel's diverticulum with gastric type of mucosa

Obstructive internal hernia caused by mesodiverticular bands in children

Sudden Death Associated With Incarcerated Small Bowel Due to Mesodiverticular Band

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