[Meckel's diverticulitis, an uncommon cause of acute abdomen]. / Diverticulitis de Meckel, una causa poco frecuente de abdomen agudo.

Meckel's diverticulum corresponds to the aberrant involution of the omphalo-mesenteric canal or vitelline duct, which is located at the level of the antimesenteric border of the terminal ileum. It is the most common structural anomaly of the gastrointestinal tract, it is almost always asymptomatic and its diagnosis is usually incidental, however the complication with diverticulitis is an unusual condition. We describe the case of a 65-year-oldman, who was admitted from another institution with a diagnosis of acute abdomen. On physical examination, he presented signs of peritoneal irritation with evidence of leukocytosis and neutrophilia in the admission blood count. Computerized tomography of the abdomen with intra venous contrast was performed, which was interpreted as complicated Meckel's diverticulitis, being corroborated during the surgical act and confirmed by pathological anatomy. Meckel's diverticulitis is a rare entity, however it is important to recognize it within the differential diagnoses of acute abdomen, which will allow prompt intervention and a favorable outcome.

El divertículo de Meckel (DM) corresponde a la involución aberrante del canal onfalo-mesentérico o conducto vitelino, el cual se ubica a nivel del borde antimesentérico del íleon terminal. Es la anomalía estructural más común del tracto gastrointestinal, casi siempre es asintomático y su diagnóstico por lo general es incidental, sin embargo, la complicación con diverticulitis es una condición poco usual. Describimos el caso de un hombre de 65 años, que ingresó referido de otra institución con diagnóstico de abdomen agudo, al examen físico presentó signos de irritación peritoneal con evidencia de leucocitosis y neutrofilia en hemograma de ingreso. Se realizó tomografía computarizada de abdomen con contraste endovenoso, la cual se interpretó como diverticulitis de Meckel complicada, siendo corroborado durante el acto quirúrgico y confirmado mediante anatomía patológica. La diverticulitis de Meckel es una entidad rara, sin embargo, es importante reconocerla dentro de los diagnósticos diferenciales de abdomen agudo, lo cual permitirá una pronta intervención y un favorable desenlace.

Tc-99m scan for pediatric bleeding Meckel diverticulum:a systematic review and meta-analysis.

OBJECTIVE: Meckel diverticulum (MD) is a common malformation of the digestive tract, often accompanied by serious complications. It is important to find safe and effective diagnostic methods for screening MD. The aim of this study was to evaluate the effectiveness of a technetium-99m (Tc-99m) scan for pediatric bleeding MD. METHODS: The authors conducted a systematic review of studies published in PubMed, Embase, and Web of Science before 1 January 2023. Studies based on PICOS were included in this systematic review. The flow chart was made by PRISMA software. The quality of included studies was assessed by RevMan5 software (QUADAS-2: Quality Assessment of Diagnostic Accuracy Studies-2). The sensitivity, specificity, and other measurements of accuracy were pooled using Stata/SE 12.0 software. RESULTS: Sixteen studies with 1115 children were included in this systematic review. A randomized-effects model was used for the meta-analysis because of significant heterogeneity. The combined sensitivity and specificity were 0.80 [Confidence Interval (95% CI, 0.73-0.86) and 0.95 (95% CI, 0.86-0.98)], respectively. The area under the curve (AUC) was 0.88 (95% CI, 0.85-0.90). Publication bias (Begg's test p = 0.053) was observed. CONCLUSION: Tc-99m scan has high specificity, but moderate sensitivity, which is always influenced by some factors. Hence, the Tc-99m scan has some limitations in the diagnosis of pediatric bleeding MD.

Intestinal intussusception of Meckel's diverticulum, a case report and literature review of the last five years.

Meckel's diverticulum is the most common gastrointestinal tract anomaly. It arises from the incomplete closure of the omphalomesenteric conduit, which is a true diverticulum at the antimesenteric border of the ileum. Although the majority of patients are asymptomatic, they can present with inflammation, hemorrhage, intussusception, intestinal obstruction, and perforation, among others; this constitutes an important differential diagnosis for acute abdomen. A 19-year-old female sought medical attention because of intermittent diffuse abdominal pain for two months, nausea, and diarrhea. In the requested imaging tests, tomography, and enterotomography, a diagnosis of Meckel's diverticulum with some degree of intussusception was suggested. The patient underwent elective surgical treatment without complications and was discharged on the second postoperative day with clinical improvement. In this section, we review publications on similar cases published in the last five years.

Subacute Meckel's diverticulum perforation.

Meckel's diverticulum is the most common intestinal congenital defect, its prevalence is 0.2%-4.0% and it occurs more commonly in children younger than 2-year old with intestinal bleeding and abdominal pain. Perforation in the elderly is very rare with no more than 35 articles reported worldwide. Here we report the case of a 62-year-old man who was admitted to hospital with a history of acute abdominal pain with a 20-day onset. The patient was treated with laparotomy and 30 cm ileal resection was performed for an 8×5 cm perforated ileum tumour at 50 from ileocecal valve with a side-to-side mechanical anastomosis for reconstruction. Having morbidity Clavien-Dindo scale I in postsurgical and good outcome in 6-month follow-up. Meckel's diverticulum is an infrequent pathology in paediatric and even rarer in adult population, however, it is always important to keep in mind how to act when is seen either as a finding or as a complication.

Diagnóstico de divertículo de Meckel mediante cápsula endoscópica / Diagnose of Meckel's diverticulum through endoscopic capsule

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.

Divertículo de Meckel. A propósito de un caso / Meckel's diverticulum. Apropos of a case

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 (AU).

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 (AU).

Divertículo de Meckel. A propósito de un caso / Meckel's diverticulum. Apropos of a case

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.

Imágenes en divertículos del tubo digestivo: localizaciones infrecuentes. serie de casos / Imaging in infrequent digestive diverticula: case series

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.

Dumbbell-Shaped Activity on Meckel's Scintigraphy Caused by Hiatal Hernia.

A 13-month-old underwent Meckel's scintigraphy to evaluate a cause of melena. The images revealed a dumbbell-shaped activity. One side of dumbbell was located in the midline lower chest, whereas another side with similar intensity was in the normal location of the stomach. A subsequent contrast CT demonstrated a large hiatal hernia.

Horseshoe Kidney Incidentally Revealed on Meckel Scintigraphy.

An 8-year-old male patient with history of bloody stools underwent a Meckel diverticulum scintigraphy to evaluate for ectopic gastric mucosa. The static images showed 2 abnormal foci of radiotracer accumulation in the mid-abdomen. Contrary to the renal activity, the foci appeared more prominent on the anterior view and localized anteriorly to the expected kidneys location on the left lateral view. Carefully reviewed dynamic acquisition revealed faint catenary-shaped activity in this region on earlier images, gradually evolving into 2 prominent foci on later images. A horseshoe kidney was suspected, the pathology being confirmed by abdominal ultrasonography.