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Gangrenous giant Meckel's diverticulitis masquerading acute appendicitis: a surgical conundrum

Teng WW, Yeap BT, Azizan N, Hayati F, Chuah JA

ANZ J Surg, 2019 09;89(9):E379-E380.

Matched MeSH terms: Meckel Diverticulum/surgery*

Fulltext Neonatal intestinal obstruction secondary to a floppy Meckel's diverticulum successfully treated by minimal access surgery

Aziz DA, Sehat SI, Osman M, Zaki FM

BMJ Case Rep, 2012;2012.

PMID: 23242081 DOI: 10.1136/bcr-2012-006956

Meckel's diverticulum has several known complications including diverticulitis and perforation. The presence of mesodiverticular band or a band from the diverticulum to the anterior abdominal wall is also described and can cause obstruction or rotation of the small bowel leading to volvulus. Meckel's diverticulum is also well known as the lead point for intussusception. It may be lined by ectopic gastric mucosa and can cause life-threatening gastrointestinal bleeding. We report a neonate who presented with acute intestinal obstruction secondary to a large, mobile Meckel's diverticulum which due to a direct compression effect on the adjacent small bowel caused mechanical intestinal obstruction. Diagnosis was confirmed at laparoscopy, and treated by curative surgical resection. This is the first report of a large mobile Meckel's diverticulum causing small bowel obstruction due to direct compression that was managed by minimally invasive surgical resection.

Matched MeSH terms: Meckel Diverticulum/surgery

Spontaneous haemoperitoneum secondary to a Meckel's diverticulum

Jabar MF, Shaker AR, Gul YA

Acta Chir. Belg., 2004 Oct;104(5):596-8.

PMID: 15571033

Meckel's diverticulum is a relatively common gastrointestinal entity which occasionally causes complications. Meckel's diverticulum is classically described to mimic acute appendicitis when inflamed as well as being a cause of unexplained luminal gastrointestinal bleeding. An unusual cause of spontaneous non traumatic haemoperitoneum found during surgery performed for a suspected acute appendicitis in a 22-year old female is described. The patient was found to have a significant haemoperitoneum due to a bleeding serosal vessel of a Meckel's diverticulum. The diverticulum was routinely excised. It was macroscopically and histologically devoid of inflammation. The bleeding vessel was not found to be abnormal or part of an arteriovenous malformation.

Matched MeSH terms: Meckel Diverticulum/surgery

Inflammatory diseases of the bowel: a Malaysian experience

Ti TK

Aust N Z J Surg, 1979 Aug;49(4):428-31.

PMID: 115452

A 10-year experience in the diagnosis and treatment of 92 patients with inflammatory bowel diseases in Kuala Lumpur is described. Tuberculosis (34 cases) was the most common inflammatory bowel disease of surgical importance. The clinical presentation of tuberculous enteritis and Crohn's disease is similar, though tuberculosis is strongly suggested by associated pulmonary disease and radiological evidence of caecal involvement. The finding of 10 cases each of Crohn's disease and ulcerative colitis is in keeping with an increased awareness of these conditions in a developing urban society where facilities exist for thorough investigation of diarrhoeal diseases. Amoebiasis sometimes causes a granulomatous lesion simulating carcinoma. Diverticular disease of the colon as known in the West is of very rare occurrence.

Matched MeSH terms: Diverticulum/surgery

Fulltext Ileal perforation in segmental intestinal dilatation associated with omphalocoele

Thambidorai CR, Arief H, Noor Afidah MS

Singapore Med J, 2009 Dec;50(12):e412-4.

PMID: 20087543

Localised dilatation of a segment of the intestine without any macroscopically-identifiable cause is rare, and has been reported in association with omphalocoele in only 14 children up to 2006. In most of these cases, the segmental intestinal dilatation (SID) was either diagnosed incidentally, or due to presentation with partial or complete intestinal obstruction. We report, for the first time, a 37-week-old neonate with bowel perforation in SID associated with omphalocoele. In our case, a long thin vessel that resembled the mesodiverticular vessel of a Meckel's diverticulum was present in the dilated segment, supporting the view that SID and Meckel's diverticulum may be embryologically related.

Matched MeSH terms: Meckel Diverticulum/surgery

Fulltext Salpingitis isthmica nodosa: review of four cases from the General Hospital, Kota Bharu

Sathyamoorthy P

Singapore Med J, 1994 Feb;35(1):65-6.

PMID: 8009284

Four cases of salpingitis isthmica nodosa diagnosed from a total of 82 hysterosalpingograms, over a period of three years at the General Hospital, Kota Bharu, were reviewed. The diagnosis was made based on the radiographic appearance of globules of contrast medium in the periluminal tissues which were in continuity with the lumen of the fallopian tubes. Three of these patients had ectopic pregnancy. Diagnosis of salpingitis isthmica nodosa which is readily demonstrated by hysterosalpingogram, is extremely important because of its impact on ectopic pregnancy rates. Hysterosalpingography is indicated following ectopic pregnancy to show whether there is diverticulosis of the contralateral tube. By such knowledge, optimal treatment can be offered to patients wishing to attempt further conception. As the disease is relatively localised it is amenable to resection with reimplantation of the distal portion of the tube.

Matched MeSH terms: Diverticulum/surgery

Fulltext A complicated urethrovaginal fistula following an inappropriate urethral diverticulum management

Lo TS, Jaili SB, Ibrahim R

Taiwan J Obstet Gynecol, 2017 Aug;56(4):534-537.

PMID: 28805613 DOI: 10.1016/j.tjog.2016.10.004

OBJECTIVE: Urethral diverticulum is uncommon, therefore appropriate evaluation, preoperative planning and counseling must be done in order to make correct diagnosis and prevent complications.

MATERIALS AND METHODS: A case of anterior vaginal wall mass was treated elsewhere by a gynecologist as periurethral cyst abscess; incision and drainage were done but a symptom of pus discharge was observed after 2 weeks. Therefore, exploration, cyst wall excision and primary closure were done though histopathological examination surprisingly confirmed the presence of urethral tissue suggestive of diverticulum.

RESULTS: Subsequently, she developed persistent urinary leakage along with urethrovaginal fistula for which they again performed pervaginal multilayer closure. Patient was later referred to us with recurrent urethrovaginal fistula. We performed posterior urethral fistulectomy with anterior vaginal wall flap and multilayer closure. Three years follow up reveals complete recovery.

CONCLUSION: Even urethral diverticulum is a rare condition, should be kept in mind as early diagnosis and management.

Matched MeSH terms: Diverticulum/surgery*

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