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1.
J. coloproctol. (Rio J., Impr.) ; 41(3): 325-328, July-Sept. 2021. ilus
Article in English | LILACS | ID: biblio-1346427

ABSTRACT

Intestinal malrotation is a congenital anomaly caused by incomplete rotation or absence of rotation of the primitive intestine along the axis of the upper mesenteric artery during embryonic development. Embryonic development and its anatomical variations were described by Dott in 1923. Intestinal malrotation is a rare condition among adults - prevalent in a mere 0.0001% to 0.19% of the population -, and it may be associated with other anatomical deformities. It can be asymptomatic or manifest with varying intensity, from obstruction to necrosis of intestinal segments. In general, this abnormality is diagnosed in the first year of life; however, symptomsmay appear later in life,making diagnosis in adults difficult on account of non-specific symptoms. In the present study, we report a case of intestinal malrotation associated with chronic non-specific symptoms progressing to mesenteric angina. (AU)


Subject(s)
Humans , Female , Aged , Torsion Abnormality/complications , Torsion Abnormality/diagnostic imaging , Mesenteric Artery, Superior , Internal Hernia , Meckel Diverticulum/diagnosis
2.
Rev. cuba. cir ; 60(2): e1024, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1280223

ABSTRACT

Introducción: El divertículo de Meckel es la anomalía congénita más frecuente del tracto gastrointestinal. Por lo general, cursa asintomático, y su diagnóstico es transoperatorio. Cuando presenta síntomas se deben a sus complicaciones, de las cuales la perforación constituye solo el 0,5 por ciento. Objetivo: Describir las características clínico-quirúrgicas de la presentación de un paciente con divertículo de Meckel perforado por cuerpo extraño. Caso clínico: Paciente adulto de 46 años de sexo masculino, piel blanca, que acude con dolor generalizado en el abdomen que se trasladó a Fosa Ilíaca Derecha, con febrícula. Se interviene quirúrgicamente y se halla divertículo de Meckel perforado por cuerpo extraño. Conclusiones: El pronóstico de esta enfermedad depende de la evolución, diagnóstico precoz y tratamiento aplicado en las distintas complicaciones, así como de la decisión de realizar tratamiento quirúrgico en los hallazgos casuales(AU)


Introduction: Meckel's diverticulum is the most frequent congenital anomaly of the gastrointestinal tract. It is generally asymptomatic, with an intraoperative diagnosis. When it presents symptoms, they are due to its complications, of which perforation accounts for only 0.5 percent. Objective: To describe the clinical-surgical characteristics of a patient who presented with a Meckel's diverticulum perforated by a foreign body. Clinical case: 46-year-old adult patient of the male sex and white skin, who presents with generalized pain in the abdomen that moved to the right iliac fossa and low-grade fever. The patient underwent surgery and a Meckel's diverticulum was found, perforated by a foreign body. Conclusions: The prognosis of this disease depends on the evolution, early diagnosis and applied treatment according to the different complications, as well as on the decision to perform surgical treatment in accidental findings(AU)


Subject(s)
Humans , Male , Middle Aged , Gastrointestinal Tract/abnormalities , Diverticulitis/surgery , Foreign Bodies/etiology , Meckel Diverticulum/complications , Early Diagnosis
3.
Rev. colomb. cir ; 36(2): 334-337, 20210000. fig
Article in Spanish | LILACS | ID: biblio-1247567

ABSTRACT

El onfalocele o exónfalos se definen como un defecto congénito de la pared abdominal, que consiste en la herniación de las vísceras abdominales a través del anillo umbilical. Esta entidad rara vez se asocia a la comunicación del divertículo de Meckel con el saco del onfalocele. Teniendo en cuenta la escasa prevalencia de dicha entidad, compartimos el reporte de caso de un paciente recién nacido, con diagnóstico de onfalocele menor, en quien se sospechaba ruptura del saco, sin embargo, de manera intraoperatoria se encontró que la aparente ruptura del saco, correspondía a la comunicación con un divertículo de Meckel. El caso además se asoció con hallazgos ecocardiográficos de tetralogía de Fallot


Omphalocele or exomphalos are defined as a congenital defect of the abdominal wall, which consists of the herniation of the abdominal viscera through the umbilical ring. This entity is rarely associated with the communication of Meckel's diverticulum with the omphalocele sac. Considering the low prevalence of this entity, we report the case of a newborn with a diagnosis of minor omphalocele, in whom rupture of the sac was suspected; however, intraoperatively it was found that the apparent rupture of the sac corresponded to a communication with a Meckel's diverticulum. The case was also associated with echocardiographic findings of tetralogy of Fallot


Subject(s)
Humans , Meckel Diverticulum , Sutures , Tetralogy of Fallot , Hernia, Umbilical
4.
Rev. cuba. med. mil ; 50(1): e774, 2021. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1289507

ABSTRACT

Introducción: La incidencia del divertículo de Meckel en la población general, es aproximadamente del 1 al 2 por ciento y las manifestaciones clínicas son vistas en solo el 20 por ciento de estas personas. El diagnóstico en el 80 por ciento restante es incidental y se hace por hallazgos quirúrgicos. La forma oclusiva de presentación es infrecuente y requiere un elevado índice de sospecha. Objetivos: Describir la presentación clínica y características quirúrgicas de la oclusión intestinal mecánica por divertículo de Meckel en el adulto. Caso clínico: Paciente masculino de 54 años de edad, que acudió por un cuadro doloroso abdominal y elementos clínicos de un síndrome oclusivo. Durante la intervención quirúrgica se constató un divertículo de Meckel de base ancha, como punto de fijación y vólvulo del intestino delgado. Se realizó resección y anastomosis término - terminal en un plano. La evolución postoperatoria fue satisfactoria. Conclusiones: La oclusión intestinal mecánica, secundaria al divertículo de Meckel, constituye una causa infrecuente de síndrome oclusivo que se debe tener presente en la práctica quirúrgica(AU)


Introduction: The incidence of Meckel's diverticulum in the general population is approximately 1 to 2 percent and clinical manifestations are seen in only 20 percent of these people. The diagnosis in the remaining 80 % is incidental and is made by surgical findings, reported in approximately 2 percent of autopsies. Objective: To describe the clinical presentation and surgical characteristics of mechanical intestinal occlusion by Meckel's diverticulum in the adults. Clinical case: 54-year-old male patient who was attended with a painful abdominal condition and clinical elements of an occlusive syndrome. During surgery, a broad-based Meckel's diverticulum was found as a point of attachment, and small intestine volvulus. A terminal resection and anastomosis was performed in one plane. Postoperative evolution was satisfactory. Conclusions: Mechanical intestinal occlusion secondary to Meckel's diverticulum is a rare cause of occlusive syndrome that must be taken into account in surgical practice(AU)


Subject(s)
Humans , Male , Middle Aged , Surgical Procedures, Operative , Intestinal Volvulus , Intestine, Small , Meckel Diverticulum/surgery
5.
Gastroenterol. latinoam ; 32(1): 14-17, 2021. ilus
Article in Spanish | LILACS | ID: biblio-1352376

ABSTRACT

Meckel's diverticulum can be present in up to 1.2% of the population. It is usually diagnosed as an imaging finding, but it can present with complications such as digestive bleeding, intestinal obstruction, diverticulitis, ulcers, and perforation, more frequently in childhood or infancy. The diagnosis workup for this condition will depend on their clinical manifestation, the most frequent being gastrointestinal bleeding of obscure origin or small intestinal bleeding. In this context, although capsule endoscopy is the preferred technique, its diagnostic yield for the detection of Meckel's diverticulum is not entirely clear and it has not been compared in a controlled studies with other diagnostic methods. Here we report the diagnosis of a Meckel diverticulum and its intestinal complications by means of capsule endoscopy in a patient with iron deficiency anemia and gastrointestinal bleeding


El divertículo de Meckel puede estar presente en el 1,2% de la población general. Usualmente es diagnosticado como un hallazgo, pero puede presentarse con mayor frecuencia en la niñez o infancia por sus complicaciones como hemorragia digestiva, obstrucción intestinal, diverticulitis, úlceras y perforación. El enfrentamiento diagnóstico de esta condición dependerá de la manifestación clínica, siendo lo más frecuente hemorragia digestiva de origen oscuro o de intestino delgado. En este contexto, si bien la cápsula endoscópica es la técnica de elección, su rendimiento diagnóstico para la detección del divertículo de Meckel no es del todo claro y no ha sido comparado de forma controlada con otras técnicas diagnósticas. En el presente caso se reporta el diagnóstico de un divertículo de Meckel y sus complicaciones intestinales mediante cápsula endoscópica en una paciente con anemia ferropriva y hemorragia digestiva.


Subject(s)
Humans , Female , Adolescent , Capsule Endoscopy/methods , Meckel Diverticulum/diagnostic imaging , Tomography, X-Ray Computed
6.
Rev. cir. (Impr.) ; 72(4): 347-349, ago. 2020. ilus
Article in Spanish | LILACS | ID: biblio-1138721

ABSTRACT

Resumen Introducción: Los hongos dematiáceos se caracterizan por la presencia de abundante melanina en su pared celular. Presentan una distribución mundial, siendo más comunes en climas tropicales y subtropicales. Producen infecciones cutáneas y subcutáneas, además de enfermedades alérgicas, neumonías, abscesos cerebrales o infecciones diseminadas. Caso Clínico: Presentamos el caso de un paciente con adenocarcinoma de recto intervenido quirúrgicamente con hallazgo incidental de divertículo de Meckel y en el cual en el estudio anatomopatológico reveló la presencia de un hongo dematiáceo


Introduction: Dematiaceous fungi are characterized by the presence of brown melanine or melanine like pigments in their cell wall. They are generally distributed worldwide, being more common in tropical and subtropical climates. The clinical syndromes are often cutaneous and subcutaneous infections, but can be also responsible of allergic diseases, pneumonias, cerebral abscesses or disseminated infections. Clinical Case: We present the case of a patient with a diagnosis of rectal adenocarcinoma intervening surgically and with an incidental finding of Meckel's Diverticulum. The anatomopathological study revealed the presence of a dematiaceous fungi.


Subject(s)
Humans , Male , Aged , Diverticulitis/surgery , Alternaria/pathogenicity , Meckel Diverticulum/surgery , Colostomy/methods
7.
Rev. méd. Panamá ; 40(1): 36-40, ene.2020. ilus, tab
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1099765

ABSTRACT

El divertículo de Meckel complicado es poco frecuente en el adulto. Presentamos un paciente de 19 años de edad, con dolor abdominal de 11 horas de evolución, encon­ trando al realizar la laparotomía exploradora un divertículo de Meckel gigante, necrosa­ do y volvulado. Las presentaciones más frecuentes del divertículo de Meckel son la obstrucción intestinal y la diverticulitis, esta última da una sintomatología similar a la apendicitis aguda, por lo que al realizar la exploración quirúrgica y encontrar el apéndi­ ce cecal normal, se debe visualizar los últimos 180 cm de íleo terminal.


Meckel's diverticulum is rare in adults. We present a 19­year­old patient with abdominal pain of 11 hours of evolution, finding a giant Meckel diverticulum, necrotic and volvula­ ted, when performing the exploratory laparotomy. The most frequent presentations of Meckel's diverticulum are intestinal obstruction and diverticulitis, the latter being a symptomatology similar to acute appendicitis, surgical surgery and the normal cecal ap­ pendix, the last 180 cm of terminal ileum should be visualiz


Subject(s)
Humans , Male , Female , Adolescent , Adult , Meckel Diverticulum/surgery , Meckel Diverticulum/diagnosis , Meckel Diverticulum/history , Gastrointestinal Tract/pathology , Diverticulitis
8.
Article in Chinese | WPRIM | ID: wpr-828629

ABSTRACT

OBJECTIVE@#To evaluate the value of capsule endoscopy in children with small intestinal diseases with hematochezia as the chief complaint.@*METHODS@#A retrospective analysis was performed on the clinical data and capsule endoscopy findings of 93 children with hematochezia who were admitted to Children's Hospital of Fudan University from May 2015 to January 2019 and underwent capsule endoscopy. According to the capsule endoscopy findings of the jejunum and the ileum, they were divided into a positive lesion group with 39 patients and a negative lesion group with 54 patients. Related clinical data and the features of lesion on capsule endoscopy were analyzed for the two groups.@*RESULTS@#There were no significant differences in age, sex, duration of capsule endoscopy, gastric transit time, and small intestinal transit time between the positive lesion and negative lesion groups (P>0.05). The positive lesion group had a significantly lower level of hemoglobin than the negative lesion group (P<0.05). Hemoglobin level was negatively correlated with the rate of positive lesions on capsule endoscopy (r=-0.342, P=0.001). Among the 39 patients with positive lesions on capsule endoscopy, the detection of Meckel's diverticulum was the highest (41%), followed by inflammatory bowel disease (21%).@*CONCLUSIONS@#Capsule endoscopy has a certain value in detecting small intestinal diseases, especially diseases in the jejunum and the ileum, in children with lower gastrointestinal hemorrhage.


Subject(s)
Capsule Endoscopy , Child , Gastrointestinal Hemorrhage , Humans , Intestinal Diseases , Jejunum , Meckel Diverticulum , Retrospective Studies
9.
Rev. Méd. Paraná ; 78(2): 84-86, 2020.
Article in Portuguese | LILACS | ID: biblio-1222990

ABSTRACT

O divertículo de Meckel (DM) é um vestígio remanescente do ducto vitelino que se forma entre a oitava e nona semanas de gestação. É uma manifestação relativamente comum na população geral (2%), no entanto, raramente desenvolve sintomas. Quando desenvolve sintomas a hematoquezia indolor é o sintoma mais prevalente. A investigação da hematoquezia dolorosa requer a exclusão de diversas patologias gastrointestinais. No presente artigo relatamos o caso de um paciente com DM de apresentação clínica e epidemiologia atípicas e sua investigação, assim como uma revisão de literatura sobre os métodos diagnósticos para se chegar ao DM.


Meckel's diverticulum (DM) is a remnant of the vitelline duct that forms between the eighth and ninth weeks of gestation. It is a relatively common manifestation in the general population (2%), however, it rarely develops symptoms. When symptoms develop, painless hematochezia is the most prevalent symptom. The investigation of painful hematoquezia requires the exclusion of several gastrointestinal pathologies. In the present article we report the case of a patient with atypical clinical and epidemiology DM presentation and it´s investigation, as well as a literature review on the diagnostic methods to arrive at DM.


Subject(s)
Humans , Gastrointestinal Hemorrhage , Meckel Diverticulum , Abdominal Pain
10.
Rev. cuba. cir ; 58(2): e648, mar.-jun. 2019. graf
Article in Spanish | LILACS | ID: biblio-1093166

ABSTRACT

RESUMEN Se presenta el caso de un paciente masculino de 39 años de edad, que acude al cuerpo de guardia del Hospital General Docente Abel Santamaría Cuadrado por presentar un cuadro de dolor abdominal de tres días de evolución. Se interviene quirúrgicamente con el diagnóstico presuntivo de apendicitis aguda complicada. En el acto quirúrgico se comprobó que el apéndice cecal era normal y al examinar el íleon terminal, a una distancia aproximada de 50 cm se encontró un divertículo de Meckel, y a 5 cm de este, una espina de pescado adherida a la pared intestinal, la cual parecía ser la causante del cuadro, ya que el divertículo también era normal. El tratamiento consistió en trasladar la espina hacia el divertículo y realizar resección intestinal de ese tramo con anastomosis término-terminal. La evolución posoperatoria fue satisfactoria y el paciente fue dado de alta a los 8 días de la operación(AU)


ABSTRACT We present the case of a male patient, 39 years of age, who presents to the emergency room of Abel Santamaría Cuadrado General Teaching Hospital with a clinical picture of abdominal pain of three days of natural history. He is surgically intervened with the presumptive diagnosis of complicated acute appendicitis. In the surgical act, the cecal appendix was verified to be normal and, when examining the terminal ileum, at a distance of approximately 50 cm, a Meckel's diverticulum was found, and, at 5 cm from this, a fish spine adhered to the intestinal wall, which seemed to be the cause of the clinical picture, since the diverticulum was also normal. The treatment consisted of transferring the spine to the diverticulum and performing intestinal resection of that section with end-to-end anastomosis. The postoperative evolution was satisfactory and the patient was discharged 8 days after the operation(AU)


Subject(s)
Humans , Male , Adult , Appendicitis/diagnosis , Abdominal Pain/etiology , Foreign Bodies/surgery , Intestine, Small/diagnostic imaging , Meckel Diverticulum/surgery
11.
Rev. pediatr. electrón ; 16(1): 2-5, abr. 2019.
Article in Spanish | LILACS | ID: biblio-998400

ABSTRACT

El Divertículo de Meckel es la malformación congénita más común del sistema gastrointestinal1 , se produce al obliterarse el conducto onfalomesentérico a nivel proximal formando un divertículo verdadero en el borde anti mesentérico a nivel del íleon, el cual debería cerrarse entre la 5ta y 6ta semana de gestación normalmente. Sus alteraciones pueden dar lugar a pólipos ductales, bandas fibrosas, quistes ductales, fístulas íleoumbilicales o más frecuentemente al Divertículo de Meckel; estas variaciones pueden asociarse a otras malformaciones en el sistema nervioso o cardiovascular2 . Los remanentes onfalomesentéricos son más frecuentes en hombres que en mujeres, con una relación 2:1, siendo la incidencia general de un 2%3 . La mayoría de los casos se mantienen asintomáticos, pero algunos pacientes, sobre todo en edades pediátricas, pueden presentar síntomas como hemorragia gastrointestinal, torsión intestinal, obstrucción o infección4 . Dada su escasa e inespecífica sintomatología, es que podría llevar al clínico a confundirlo con otros diagnósticos diferenciales tales como la Enfermedad Inflamatoria Intestinal, Úlceras u otras patologías. Esta una de las razones por las que nos parece relevante realizar una revisión de las técnicas diagnósticas disponibles en la actualidad con el fin de determinar las mejores opciones diagnosticas dependiendo del medio en que se desenvuelva el clínico.


Meckel Diverticulum is the most common congenital malformation of the gastrointestinal system1 , it occurs when the omphalomesenteric duct is obliterated proximally, forming a true diverticulum in the anti-mesenteric border at the level of the ileum, which should be closed usually between the 5th and 6th week of gestation. Its alterations can give rise to ductal polyps, fibrous bands, ductal cysts, ileo-umbilical fistulas or more frequently to Meckel's diverticulum; These variations can be associated with other malformations in the nervous or cardiovascular system2 . Omphalomesenteric remnants are more frequent in men than in women, with a 2: 1 ratio, with a general incidence of 2% 3 . Most cases remain asymptomatic, but some patients, especially at pediatric ages, may present symptoms such as gastrointestinal bleeding, intestinal torsion, obstruction or infection4 . Given its scarce and unspecific symptomatology, it could lead the clinician to confuse it with other differential diagnoses such as Inflammatory Bowel Disease, Ulcers or other pathologies. This is one of the reasons why it seems relevant to review the diagnostic techniques currently available to determine the best diagnostic options depending on the environment in which the clinician operates


Subject(s)
Humans , Child , Gastrointestinal Hemorrhage/etiology , Meckel Diverticulum/complications , Meckel Diverticulum/diagnosis , Diagnosis, Differential
12.
Rev. medica electron ; 41(1): 173-179, ene.-feb. 2019. graf
Article in Spanish | LILACS, CUMED | ID: biblio-991335

ABSTRACT

RESUMEN El divertículo de Meckel es una evaginación en dedo de guante del borde antimesentérico del íleon, constituido por sus capas, debido a una persistencia embriológica del extremo proximal del conducto onfalomesentérico. Forma una bolsa a manera de tubo y que puede extenderse hasta la región umbilical, su inflamación (diverticulitis) produce un cuadro clínico semejante al de la apendicitis aguda, por lo que su diagnóstico preoperatorio es raro. Por lo infrecuente, los médicos no piensan seriamente en esta patología y su diagnóstico definitivo se realiza durante el transoperatorio. Se presentó un caso por lo infrecuente que resulta lo cual aporta conocimiento a la comunidad médica sobre el tema. Paciente de 68 años, acude al centro con dolor tipo cólico, taquicardia y fiebre de 38.5C°, con 24 h de evolución. Refiere que el dolor se le hizo fijo hacia fosa iliaca derecha, el cual se fue intensificando. Se decidió su ingreso para tratamiento quirúrgico. Se realizó apendicectomia y resección y anastomosis en la zona del divertículo. Se recibió biopsia informando diverticulitis de Meckel.


ABSTRACT Meckel's diverticulum is an evagination resembling a glove finger of the ileum anti-mesenteric edge, formed by layers due to an embryologic persistence of the proximal end of omphalo-mesenteric duct. It forms a sac like a tube that may extend up to the umbilical region; its inflammation (diverticulitis) has clinical characteristics similar to the acute appendicitis ones, making its pre-surgery diagnosis very unusual. Due to its frequency, doctors often do not take this disease into account, and it is definitely diagnosed during the trans-operative. The case was presented due to its infrequency, bringing knowledge on the theme to medical community. A patient aged 68 years assisted the hospital with a colic-like pain, tachycardia and fiver of 38.5oC after 24 hours of evolution. He refers that the pain became fixed in the right iliac fosse and got more intensity. The decision was entering him for surgical treatment. Appendectomy, resection and anastomosis were carried out in the area of the diverticulum. The received biopsy informed Meckel's diverticulum.


Subject(s)
Humans , Male , Aged, 80 and over , Radiography, Thoracic/methods , Hemostasis , Meckel Diverticulum/surgery , Meckel Diverticulum/diagnosis , Meckel Diverticulum/blood , Meckel Diverticulum/diagnostic imaging , Pain/diagnosis , Colic/diagnosis , Ilium/physiopathology
13.
Article in English | WPRIM | ID: wpr-719680

ABSTRACT

We report a rare case of Meckel's diverticulum in a boy who initially presented with chronic iron deficiency anemia (IDA) without any history of gastrointestinal (GI) bleeding at 8 years-old. Isolated small bowel Crohn's disease was suspected based on findings of small bowel ulcers on capsule endoscopy. At four years from initial presentation, he developed massive GI bleeding. Abdominal computed tomographic angiography and small bowel series revealed findings suggestive of Meckel's diverticulum. Meckel's diverticulum should be suspected in children with unexplained chronic IDA even in the absence of prominent GI bleeding and negative findings on repetitive Meckel's scans. Moreover, Meckel's diverticulum should be included in the differential diagnosis of isolated small bowel Crohn's disease when the disease is limited to a short segment of the distal small bowel, as ulcers and inflammation may result as a consequence of acid secreted from adjacent heterotopic gastric mucosa constituting the Meckel's diverticulum.


Subject(s)
Anemia, Iron-Deficiency , Angiography , Capsule Endoscopy , Child , Crohn Disease , Diagnosis, Differential , Gastric Mucosa , Hemorrhage , Humans , Inflammation , Male , Meckel Diverticulum , Ulcer
14.
Article in English | WPRIM | ID: wpr-741835

ABSTRACT

Bowel ischemia is a life-threatening surgical emergency. We report a case of rapidly progressive bowel necrosis in a previously healthy child without proven mechanical small bowel obstruction. The definite diagnosis was established at the time of an exploratory operation. Of note, imaging studies and even a laparotomy did not reveal any evidence of acute appendicitis or mechanical obstruction such as intussusception or Meckel's diverticulum. During hospitalization, since we could not rule out surgical abdomen after inconclusive image findings, we closely followed the patient and repeated physical examinations carefully. Eventually surgical exploration was performed based on changes in clinical condition, which proved to be the right decision for the patient. We propose that in children with suspected strangulation of small bowel obstruction, especially when imaging findings do not provide a conclusive diagnosis, the timely exploratory surgical approach ought to be chosen based on carefully observed clinical findings and other evaluations.


Subject(s)
Abdomen , Appendicitis , Child , Diagnosis , Emergencies , Hospitalization , Humans , Intestine, Small , Intussusception , Ischemia , Laparotomy , Meckel Diverticulum , Mesenteric Ischemia , Necrosis , Physical Examination
15.
Article in Spanish | LILACS, BNUY, UY-BNMED | ID: biblio-1283458

ABSTRACT

La persistencia del conducto onfalomesentérico permeable es una de las formas de presentación menos frecuente, dentro de la patología, de los restos embrionarios derivados de este conducto. Se presenta el caso de un lactante de 30 días de vida a quien se le hace un diagnóstico de conducto onfalomesentérico permeable y se realiza cirugía resectiva, con una buena evolución postoperatoria inmediata y con alta a domicilio a los 8 días. Se revisan los datos de embriología así como de patología, la presentación clínica, los diagnósticos diferenciales y las opciones terapéuticas.


The persistence of permeable omphalosenteric duct is one of the less frequent forms of presentation, within the pathology, of the embryonic remnants derived from this duct. We present the case of a 30-day-old infant who is diagnosed with permeable omphalomesenteric duct, and resective surgery is performed, with a good postoperative evolution and with home discharge at 8 days. The embryology data as well as the pathology, the clinical presentation, the differential diagnoses and the therapeutic options are reviewed.


A persistência do ducto onfalossentérico permeável é uma das formas menos freqüentes de apresentação, dentro da patologia, dos remanescentes embrionários derivados desse ducto. Apresentamos o caso de um lactente de 30 dias que é diagnosticado comducto oncomumentérico permeável, sendo realizada cirurgia ressectiva, com boa evolução pós-operatória e com descarga domiciliar aos 8 dias. Os dados da embriologia, bem como a patologia, a apresentação clínica, os diagnósticos diferenciais e as opções terapêuticas são revisados.


Subject(s)
Humans , Infant, Newborn , Vitelline Duct/surgery , Vitelline Duct/pathology , Diverticulitis , Meckel Diverticulum/surgery , Meckel Diverticulum/diagnosis , Vitelline Duct/abnormalities , Intestinal Fistula/surgery
16.
Rev. cuba. cir ; 57(3): e694, jul.-set. 2018. graf
Article in Spanish | LILACS | ID: biblio-985522

ABSTRACT

Introducción: El divertículo de Meckel es el remanente de la porción proximal del conducto vitelino y representa la anomalía congénita más frecuente del aparato gastrointestinal. Objetivo: Definir el valor de los métodos de diagnóstico actuales, las complicaciones y sus causas y el tratamiento apropiado del divertículo de Meckel. Métodos: Se realizó la revisión de la literatura en PubMed/Medline y en Infomed con las palabras clave Meckel´s diverticulum, diagnosis, complicaciones, tratamiento y las correspondientes en español, publicados en los últimos 5 años. Se incluyeron, de preferencia, los artículos dedicados a series de casos. Se excluyeron los dedicados a casos pediátricos. Resultados: Se encontraron 4260 artículos en Medline/Pubmed y 17 en Infomed. No se encontraron ensayos clínicos, metanálisis, ni revisiones sistemáticas. La mayoría de los artículos revisados hacen referencia a presentación de casos y algunos fueron estudios retrospectivos. Conclusiones: El divertículo de Meckel es raro en adultos y, regularmente, se diagnostica durante una laparotomía por otras causas. El diagnóstico preoperatorio es difícil porque los síntomas simulan los de otras afecciones del cuadrante inferior derecho; apendicitis aguda la más frecuente. La imaginología, principalmente la TAC, juega un rol importante en el diagnóstico preoperatorio. El tratamiento quirúrgico del divertículo de Meckel encontrado incidentalmente, es controversial. El divertículo sintomático debe ser extirpado conjuntamente con una porción del íleon adyacente, por la posibilidad de mucosa ectópica gástrica o pancreática, además de tumores asociados. Los índices de mortalidad en estos pacientes son altos. El diagnóstico temprano evita complicaciones adicionales y la hospitalización prolongada(AU)


Introduction: Meckel's diverticulum is the remnant of the proximal portion of the vitelline duct and represents the most frequent congenital abnormality in the gastrointestinal tract. Objective: To define the value of current diagnostic methods, complications and their causes, and the appropriate treatment for Meckel's diverticulum. Methods: Literature review was carried out in PubMed/Medline and Infomed, with the keywords Meckel's diverticulum, diagnosis, complications, treatment and the corresponding Spanish words, published in the last 5 years. Preferably, we included the articles about case series. We excluded those dedicated to pediatric cases. Results: 4260 articles were found in Medline/Pubmed and 17, in Infomed. No clinical trials, meta-analyzes or systematic reviews were found. Most of the articles reviewed refer to case presentations and some were retrospective studies. Conclusions: Meckel's diverticulum is rare in adults and is regularly diagnosed during a laparotomy for other causes. The preoperative diagnosis is difficult because the symptoms simulate those for other conditions of the right lower quadrant, acute appendicitis being the most frequent. Imaging techniques, mainly CAT, play an important role in the preoperative diagnosis. The surgical treatment for Meckel's diverticulum incidentally found is controversial. The symptomatic diverticulum must be removed together with a portion of the adjacent ileum, due to the possibility of gastric or pancreatic ectopic mucosa, as well as associated tumors. Mortality rates in these patients are high. Early diagnosis avoids additional complications and prolonged hospital stay(AU)


Subject(s)
Humans , Meckel Diverticulum/complications , Meckel Diverticulum/diagnosis , Review Literature as Topic , Retrospective Studies , Meckel Diverticulum/therapy
17.
Rev. cuba. med. mil ; 47(3): 1-7, jul.-set. 2018. ilus
Article in Spanish | LILACS, CUMED | ID: biblio-985541

ABSTRACT

Introducción: La hernia de Littré se define como la presencia de un divertículo de Meckel en cualquier saco herniario, su incidencia es de alrededor de un 2 por ciento y se han descrito pocos casos en la literatura. Objetivo: Presentar un caso inusual de cirugía de urgencia con un cuadro de oclusión intestinal por hernia de Littré, operado en el servicio de urgencias del Hospital Militar Dr. Carlos J. Finlay. Caso clínico: Paciente de 79 años de edad que consulta por cuadro de dolor abdominal, vómitos y aumento de volumen en la región crural derecha, operado con diagnóstico presuntivo de hernia crural complicada. Se realiza abordaje preperitoneal, se encontró en el saco herniario, un divertículo de Meckel con compromiso vascular. Fue resecado completamente, efectuada anastomosis término-terminal del íleon y reparado defecto herniario con técnica de Cheatle-Henry. Comentarios: La paciente recibió resección intestinal y reparación tisular del anillo crural, recibió alta hospitalaria al tercer día y médica a los 45 días de la operación(AU)


Introduction: Littré hernia is defined as the presence of a Meckel diverticulum in any hernia sac, the incidence is around 2 percent and few cases have been described in the literature. Objective: To present an unusual case of emergency surgery with intestinal occlusion due to Littré's hernia operated in the emergency service of the Military Hospital Dr. Carlos J. Finlay. Clinical case: A 79-year-old patient who consulted due to abdominal pain, vomiting and increased volume in the right crural region, he was operated with a presumptive diagnosis of complicated crural hernia. A preperitoneal approach was performed, a Meckel diverticulum with vascular compromise was found in the hernia sac. It was completely resected, end-to-end anastomosis of the ileum was performed and hernial defect repaired with the Cheatle-Henry technique. Comments: this patient received intestinal resection and tissue repair of the crural ring. She was discharged on the third day and medically discharge 45 days after the operation(AU)


Subject(s)
Humans , Female , Aged , Herniorrhaphy/methods , Meckel Diverticulum/surgery
18.
Rev. chil. cir ; 70(4): 358-361, ago. 2018. ilus
Article in Spanish | LILACS | ID: biblio-959396

ABSTRACT

Resumen Introducción: El divertículo de Meckel (DM) es una anomalía congénita gastrointestinal producto de obliteración incompleta del conducto onfalomesentérico, habitualmente en menores de dos años. Como complicación destaca obstrucción intestinal, intususcepción e inflamación. Caso Clínico: Paciente de sexo masculino, 19 años, sin antecedentes mórbidos. Ingresa a Urgencias por dolor abdominal, 24 h de evolución, que inicia en mesogastrio y luego irradia a fosa ilíaca derecha (FID), intenso, asociado a vómitos, fiebre y taquicardia. Al examen abdominal destaca resistencia muscular, dolor en FID, Blumberg positivo y ruidos hidroaéreos disminuidos. Se realiza laparotomía de McBurney hallándose gran cantidad de líquido libre citrino viscoso y signos de obstrucción de intestino delgado; decidiendo cierre de laparotomía de McBurney y realizar laparotomía media infraumbilical. Se encuentra divertículo de Meckel torcido y estrangulado, con brida hacia raíz del mesenterio de intestino delgado distal. Se realiza resección DM y bridolisis, recuperando vitalidad de asa y apendicectomía profiláctica. Discusión: El diagnóstico preoperatorio del DM es infrecuente y requiere exploración quirúrgica. El DM volvulado es raro, en nuestro caso produjo obstrucción intestinal secundaria a brida entre DM y mesenterio.


Introduction: Meckel's diverticulum is the most frequent gastrointestinal anomaly. It's more frequently seen in children less than 2 years of age. It's caused by the incomplete obliteration of the omphalomesenteric conduct. Case report: 19 year old male patient with no previous medical history presents sudden onset of high intensity abdominal pain, initially located in the periumbilical region, radiating to right lower quadrant associated with emesis, fever and tachycardia. Physical examination showed abdominal guarding, rebound tenderness and decreased bowel sounds. During McBurney laparotomy a large volume of viscous free fluid was found and signs of small bowel obstruction, deciding close McBurney laparotomy and performing sub-umbilical midline laparotomy. Meckel diverticulum is founded, twisted and strangled, with a bridle adhesion to the mesenteric root, compromising the small bowel. The adherence and the MD are resected, obtaining appropriate peristaltic activity and color. Appendectomy and peritoneal lavage are performed without complications. Discussion: preoperatory diagnosis of MD is unfrequented and its need surgical exploration. MD's volvulus is infrequent and in our case, intestinal obstruction it's secondary to an adherence between the volvulated MD and the mesentery.


Subject(s)
Humans , Male , Young Adult , Intestinal Obstruction/etiology , Meckel Diverticulum/complications , Abdomen, Acute/etiology , Intestinal Obstruction/surgery , Laparotomy , Meckel Diverticulum/surgery
19.
Rev. chil. radiol ; 24(2): 67-78, jul. 2018. ilus
Article in Spanish | LILACS | ID: biblio-959579

ABSTRACT

Los divertículos se pueden localizar en todo el tubo digestivo (TD): esófago, estómago, duodeno, yeyuno, íleon, apéndice, colon. Son infrecuentes, salvo en colon. Sus manifestaciones clínicas son inespecíficas, con difícil diagnóstico y mayor riesgo de complicaciones. Se presenta una serie de divertículos digestivos atípicos, mostrando las características imagenológicas multimodalidad y describir los hallazgos claves. Es una revisión retrospectiva en el archivo computacional de nuestra institución. Selección de casos de divertículos de presentación inhabitual por sus características, localización u origen. En esófago los divertículos de Zenker y Killian-Jamieson. En estómago los divertículos gástricos infrecuentes. Los divertículos en intestino delgado tienen baja prevalencia, el más frecuente en duodeno. Los divertículos colónicos pueden tener una localización o presentación atípica. Los divertículos apendiculares y Meckel presentan baja prevalencia. Los divertículos digestivos son infrecuentes, excepto los colónicos. El radiólogo debe estar familiarizado con las diferentes ubicaciones de ellos, para reconocerlos y poder diagnosticarlos.


Diverticula may occur in any segment of the digestive tract: esophagus, stomach, duodenum, jejunum, ileum, appendix, and colon. Its clinical manifestations are nonspecifi which may turn diffiult an early diagnosis, leading to a higher risk of complications. We present a cases serie of atypical digestive diverticula and to describe the fidings on the different imaging techniques. We performed a retrospective review on the imaging computer archives of our institution. The atypical diverticula were selected. Zenker and Killian-Jamieson's diverticulums in esophagus. In stomach ocasionally gastric diverticula. Diverticula in small intestine have a low prevalence, the most common location is duodenum. Colonic diverticula may present a atypical location or presentation. The appendicular and Meckel diverticuli are uncommon. The digestive diverticula are uncommon, except the colonic ones. The radiologist must be familiar with it's different locations in order to be able to recognize it and diagnose it properly.


Subject(s)
Humans , Diverticular Diseases/diagnostic imaging , Diverticulum, Stomach/diagnostic imaging , Diverticulosis, Esophageal/diagnostic imaging , Diverticulum, Colon/diagnostic imaging , Meckel Diverticulum/diagnostic imaging
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