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[Unusual clinical presentation of Meckel's diverticulum. A case report]
C Burchi1, M Moretti, A Cavallaro
1Istituto di Clinica Chirurgica, Università degli Studi di Roma La Sapienza.
Abstract:
Meckel's diverticulum (Md) is the most common congenital anomaly of the gastrointestinal tract. It results from an incomplete obliteration of the omphalomesenteric duct during fetal life. It is frequently located on the antimesenteric border of the ileum at 80 cm from the ileum-cecal valve. It contains heterotopic mucosa in 30% of the cases and in 70% of these the mucosa is of the gastric type. The most common complication in childhood is represented by hemorrhage. Preoperative diagnosis is often difficult. Barium enema, Tc-99 scintigraphy and selective mesenteric angiography usually can permit diagnosis. In adults occlusion, perforation, diverticulum infection, Littre's hernia and tumors represent the complications of Meckel's diverticulum. A case of Md is reported because of the unusual clinical presentation.
Insights
Meckel's diverticulum, a common congenital anomaly, arises from incomplete fetal duct obliteration. Diagnosis can be challenging, with complications varying from hemorrhage in children to obstruction and tumors in adults.
Area of Science:
- Gastroenterology
- Pediatric Surgery
- Congenital Anomalies
Background:
- Meckel's diverticulum (Md) is the most frequent congenital abnormality of the gastrointestinal tract.
- It originates from the incomplete closure of the omphalomesenteric duct during fetal development.
- Typically found on the ileum's antimesenteric border, approximately 80 cm from the ileocecal valve.
Observation:
- Heterotopic mucosa, commonly gastric type (70%), is present in 30% of Meckel's diverticulum cases.
- Hemorrhage is the most frequent complication observed in childhood.
- Adult complications include obstruction, perforation, diverticulitis, Littre's hernia, and tumors.
Findings:
- Preoperative diagnosis of Meckel's diverticulum presents significant challenges.
- Diagnostic tools such as barium enema, Tc-99 scintigraphy, and selective mesenteric angiography can aid in identification.
- This report details a specific case of Meckel's diverticulum due to its atypical clinical presentation.
Implications:
- Understanding the varied presentations and complications of Meckel's diverticulum is crucial for timely diagnosis and management.
- Improved diagnostic strategies are needed, especially for challenging cases.
- Further research into the etiology and management of Meckel's diverticulum complications can enhance patient outcomes.