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2014, Number 3

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Cir Cir 2014; 82 (3)

Meckel’s diverticulum duplication. Case report and literature review

Blando-Ramírez JS, Ocádiz-Carrasco J, Gutiérrez-Padilla RA, Vicencio-Tovar A, Ricardez-García JA

Language: Spanish
References: 30
Page: 332-337
PDF size: 318.89 Kb.


ABSTRACT

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.


REFERENCES

  1. Mullassery D, Losty PD. Omphalomesenteric Duct Remnants. In: Pediatric Surgery: Diagnosis and Management, (Eds) Puri P, Höllwarth M. Springer-Verlag Berlin Heidelberg, 2009;491-496.

  2. Snyder CL. Divertículo de Meckel. En: Cirugía Pediátrica, (Eds) Ashcraft KW Murphy JP, Sigalet DL, Snyder CL. 3a ed. México: McGraw-Hill Interamericana, 2002;568-571.

  3. Matsagas MI, Fatouros M, Koulouras B, Giannoukas AD. Incidence, Complications, and Management of Meckel’s Diverticulum. Arch Surg 1995;130:143-146.

  4. Kennedy M, Liacouras CA. Meckel Diverticulum and Other remnants of the Omphalomesenteric Duct. In: Nelson Texbook of Pediatrics. (Eds) Kliegman RM, Stanton BF, Schor NF, St.Geme JW III, Behrman RE. Philadelphia: Elsevier Saunders, 2011;1281-1282.

  5. Yahchouchy EK, Marano AF, Etienne JC, Fingerhut AL. Meckel’s Diverticulum. J Am Coll Surg 2001;192:658-662.

  6. Evers BM. Divertículo de Meckel. En: Sabiston, Tratado de Cirugía. Townsend CM, Beauchamp, Evers, Mattox. 17º ed. España: Elsevier Saunders, 2007;1365-1368.

  7. Whang EE, Ashley SW, Zinner MJ. Intestino Delgado. En: Brunicardi FC. Schwartz: Principios de Cirugía, 8ª ed. México: McGraw-Hill Interamericana, 2006;1043-1045.

  8. Martin JP, Connor PD, Charles K. Meckel’s Diverticulum. Am Fam Physician 2000;61:1037-1042.

  9. Mendelson KG, Bailey BM, Balint TD, Pofahl WE. Meckel’s Diverticulum: review and Surgical Management. Curr Surg 2001;58:455-457.

  10. DiGiacomo JC, Cottone FJ. Surgical Treatment of Meckel’s Diverticulum. South Med J 1993;86:671-675.

  11. Leijonmarck CE, Bonman-Sandelin K, Frisell J, Raf L. Meckel’s diverticulum in the adult. Br J Surg 1986;73:146-149.

  12. Levy AD, Hobbs CM. Meckel Diverticulum: Radiologic Features with Phatologic Correlation. RadioGraphics 2004;24:565-587.

  13. Brown RL, Azizkhan RG. Gastrointestinal bleeding in infants and children: Meckel’s diverticulum and intestinal duplication. Semin Pediatr Surg 1999;8:202-209.

  14. Fa-Si-Oen PR, Roumen RM, Croiset van Uchelen FA. Complications and management of Meckel’s diverticulum a review. Eur J Surg 1999;165:674-678.

  15. Turgeon DK, Barnett JL. Meckel’s diverticulum. Am J Gastroenterol 1990;85:777-781.

  16. Williams RS. Management of Meckel’s diverticulum. Br J Surg 1981;68:477-480.

  17. Cullen JJ, Kelly KA, Moir CR, Hodge DO, Zinsmeister AR, Melton 3rd LJ. Surgical management of Meckel’s diverticulum. An epidemiologic, population-based study. Ann Surg 1994;220:564-569.

  18. Robijn J, Sebrechts E, Miserez M. Management of Incidentally Found Meckel’s Diverticulum A New Approach: Resection Based on a Risk Score. Acta Chir Belg 2006;106:467-470.

  19. Franklin Jr. ME, Leyva-Alvizo A, Glass JL, Treviño JM, Arellano PP, Madrigal SSA. Laparoscopic Meckel’s diverticulum resection in adults: Experience at the Texas Endosurgery Institute. Rev Mex Cir Endosc 2004;5:179-181.

  20. Gómez-Cardenas X, Decanini-Terán C, Belmonte-Montes C, Ruiz-Galindo GH, Galeazzi-Martínez V. Enfoque laparoscópico en síndrome doloroso abdominal por divertículo de Meckel. An Med Asoc Med Hosp ABC 2000;45:188-192.

  21. Luna-Lugo G, Guzman-Sanchez C. Resección ileal por doble divertículo de Meckel transcesárea. Ginecol Obstet Mex 2011;79:308-312.

  22. Álvarez-Solís RM, Reyes-Magaña JG, Vargas-Vallejo MP, Ulloa-Patiño P, Bulnes-Mendizábal D. Doble Divertículo de Meckel. Salud Tabasco 2002;8:51-57.

  23. Albu E, Solomon L, Shah AK, Ajay K, Murphy RM, Gerst PH. Double Meckel’s Diverticulum. South Med J 1992;85:1142-1144.

  24. Tauro LF, Martis JJ, Shenoy HD. Double Meckel’s diverticulum. J Indian Med Assoc 2009;107:174-175.

  25. Losanoff JE, Kjossev KT. Meckel’s diverticulum duplication. Case report. S Afr J Surg 2000;38:61-62.

  26. Urakawa M, Ikeno T, Arai T, Natori K, Miyamoto H, Kawaguchi K. Meckel’s diverticulum duplication revealed by acute operation of ileus: A case report. Nihon Shokakibyo Gakkai Zasshi 2009;106:542-545.

  27. Fajardo R, Cuevas V, Fuentes J. Doble divertículo de Meckel: resección por laparoscopia. Doble Rev Colomb Cir 2011;26:138-142.

  28. Yang JG, Ma DQ, Hao RR, Li CL, Zou LF. Detection of Double Meckel´s Diverticulum by Meckel Scan. Clin Nucl Med 2008;33:729-730.

  29. Mazza L, Garino M, Morgando A, Fronda G, Rizzetto M. A double Meckel´s diverticulum as obscure gastrointestinal bleeding cause: Report of case. Minerva Gastroenterol Dietol 2006;52:225-231.

  30. Emre A, Akbulut S, Yilmaz M, Kanlioz M, Aydin BE. Double Meckel´s Diverticulum Presenting as Acute Appendicitis: A Case Report and Literature Review. J Emerg Med 2013;44:e321-e324.




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