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Published on: November 1, 2018
[Meckel's diverticulum duplication. Case report and literature review]
Juan Salvador Blando-Ramírez1, Jesús Ocádiz-Carrasco2, Ruth Alicia Gutiérrez-Padilla3
1Cirugía general, angiologí, cirugía vascular y endovascular, Centro Médico Nacional 20 de Noviembre, ISSTE, Mexico DF, Mexico. vascsurg78@gmail.com.
Background:
Meckel's diverticulum is the most frequent congenital abnormality of the gastrointestinal tract. Preoperative diagnosis is difficult due to its variable clinical presentation that can simulate several causes of gastrointestinal bleeding or abdominal pain.
Clinical Case:
We present the case of a 61-year-old female patient with multiple abdominal surgeries who developed intestinal occlusion during several admissions beginning 8 months earlier. She was treated with conservative measures. During her last admission, she developed dehydration, persistent abdominal pain and bowel dilation with failure to respond to conservative treatment. Surgical intervention was decided upon, ruling out adhesions and revealing the presence of two diverticular defects at 40 and 70 cm from the ileocecal valve with torsion. Histological report described gastric heterotrophic mucosa and inflammatory hemorrhagic process.
Conclusion:
Presence of duplicated Meckel's diverticulum is a rare finding with only nine reports in the international literature to date. Diagnosis is frequently made during surgery. Treatment for symptomatic diverticulum is surgical, whereas management for asymptomatic diverticulum is controversial and relies on the surgeon's decision and clinical characteristics of the patient.
Insights
Duplicated Meckel
Area of Science:
- Gastroenterology
- Surgical Pathology
Background:
- Meckel's diverticulum is the most common congenital gastrointestinal anomaly.
- Diagnosis is challenging due to varied presentations mimicking other GI conditions.
Observation:
- A 61-year-old female with prior surgeries presented with recurrent intestinal obstruction.
- Conservative management failed, leading to surgical intervention.
Findings:
- Surgery revealed two Meckel's diverticula with torsion.
- Histology confirmed gastric heterotopic mucosa and inflammation.
Implications:
- Duplicated Meckel's diverticulum is exceptionally rare, often diagnosed intraoperatively.
- Surgical treatment is indicated for symptomatic cases; asymptomatic management remains debated.
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