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2018, Number 3

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Revista Cubana de Cirugía 2018; 57 (3)

Meckel´s diverticulum in adults

Fuentes VE

Language: Spanish
References: 36
Page: 1-18
PDF size: 216.50 Kb.


ABSTRACT

Introduction: Meckel's diverticulum is the remnant of the proximal portion of the vitelline duct and represents the most frequent congenital abnormality in the gastrointestinal tract.
Objective: To define the value of current diagnostic methods, complications and their causes, and the appropriate treatment for Meckel's diverticulum.
Methods: Literature review was carried out in PubMed/Medline and Infomed, with the keywords Meckel's diverticulum, diagnosis, complications, treatment and the corresponding Spanish words, published in the last 5 years. Preferably, we included the articles about case series. We excluded those dedicated to pediatric cases.
Results: 4260 articles were found in Medline/Pubmed and 17, in Infomed. No clinical trials, meta-analyzes or systematic reviews were found. Most of the articles reviewed refer to case presentations and some were retrospective studies.
Conclusions: Meckel's diverticulum is rare in adults and is regularly diagnosed during a laparotomy for other causes. The preoperative diagnosis is difficult because the symptoms simulate those for other conditions of the right lower quadrant, acute appendicitis being the most frequent. Imaging techniques, mainly CAT, play an important role in the preoperative diagnosis. The surgical treatment for Meckel's diverticulum incidentally found is controversial. The symptomatic diverticulum must be removed together with a portion of the adjacent ileum, due to the possibility of gastric or pancreatic ectopic mucosa, as well as associated tumors. Mortality rates in these patients are high. Early diagnosis avoids additional complications and prolonged hospital stay.


REFERENCES

  1. Cotirlet A, Anghel R, Tincu E, Rau S, Motoc I, Popa E, Perforation of Meckel’sdiverticulum by foreign body, a rare complication, Chirurgia (Bucur). 2013;108(3):411–3.

  2. Darlington CD, Anitha GFS. 2. Meckel's Diverticulitis Masquerading as Acute Pancreatitis: A Diagnostic Dilemma. Indian J Crit Care Med. 2017;21(11):789-92.

  3. Yildiz I, Koca YS, Barut I. An unusual case of intraabdominal abscess and acute abdomen caused by axial torsion of a Meckel's diverticulum. Annals of Medicine and Surgery. 2016;6:74e76.

  4. Chatterjee A, Harmath C, Vendrami CL, Hammond NA, Mittal P, Salem R, et al. Reminiscing on Remnants: Imaging of Meckel Diverticulum and Its Complications in Adults. AJR Am J Roentgenol. 2017;209(5):W287-W296.

  5. Lequet J, Menahem B, Alves A, Fohlen A, Mulliri A. Meckel's diverticulum in the adult. J Visc Surg. 2017;154(4):253-9.

  6. Kotha VK, Khandelwal A, Saboo S, Shanbhougue AKP, Virmani V, Marginean EC et al. Radiologist´s perspective for the Meckel´s diverticulum and its complications. Br J Radiol 2014; 87:20130743.

  7. Patel NB, Wenzke DR. Evaluating the Patient with Right Lower Quadrant Pain. Radiol Clin North Am. 2015;53(6):1159-70.

  8. Singh DR, Puligkal GG, Lo ZJ, Peh WCG. Clinics in diagnostic imaging. Singapore Med J. 2015;56(9):523-7.

  9. Lee JM, Jeen CD, Kim SH, Lee JS, Nam SJ, Choi HS, et al. Meckel's diverticulum detected by computed tomographic enterography: report of 3 cases and review of the literature. Turk J Gastroenterol. 2014;25(2):212-5.

  10. Kawamoto S, Raman SP, Blackford A, Hruban RH, Fishman EK. CT Detection of Symptomatic and Asymptomatic Meckel Diverticulum. AJR Am J Roentgenol. 2015;205(2):281-91.

  11. Megibow AJ, Sahani D. Best practice: implementation and use of abdominal dualenergy CT in routine patient care. Am J Roentgenol. 2012;99(Suppl. 5):S71–7.

  12. Tutar O, Velidedeoglu M, Yanik I, Kocak B, Bas A, Tutar B, Kantarci F. Computed tomography features of small bowel obstruction due to mesodiverticular band. JBRBTR. 2014;97(1):25-7.

  13. Zhou F-R, Huang L-Y, Xie H-Z. Meckel´s diverticulum bleeding diagnosed with magnetic resonance enterography: A case report. World J Gastroenterol. 2013;19(17):2727-30.

  14. Masuda T, Yoshioka M, Ishiyama S, Kaneto M, Saito H, Fujii M, et al. An adult case of intussusception due to inverted Meckel's diverticulum observed by colonoscopy. Nihon Shokakibyo Gakkai Zasshi. 2014;111(5):924-30.

  15. Fukushima M, Kawanami Ch, Inoue S, Okada A, Imai Y, Inokuma T. A case series of Meckel’s diverticulum: usefulness of double-balloon enteroscopy for diagnosis. BMC Gastroenterology. 2014;14:155-60.

  16. Takagaki K, Osawa S, Ito T, Iwaizumi M, Hamaya Y, Tsukui H, et al. Inverted Meckel´s diverticulum preoperatively diagnosed using double balloon enterosocopy. World J Gastroenterol. 2016;22(17):4416-20.

  17. Miyata S, Bliss DW. A gastrointestinal stromal tumor found in perforated Meckel's diverticulum. Surg Case Rep. 2016;2(1):67.

  18. Clark JK, Paz DA, Ghahremani GG. Imaging o

  19. Srisajjakul S, Prapaisilp P, Bangchokdee S. Many faces of Meckel's diverticulum and its complications. Jpn J Radiol. 2016;34(5):313-20.

  20. Cengız F, Chabowski M, Szymanska-Chabowska A, Dorobisz T, Janczak D, Jelen M, et al. A massive bleeding from a gastrointestinal stromal tumor of a Meckel's diverticulum. Srp Arh Celok Lek. 2016;144(3-4):219-21.

  21. Capelao G, Santos M, Hilário S, Laureano M, Nobre J, Gonçalves I. Intestinal Obstruction by Giant Meckel´s Diverticulum. GE Port J Gastroenterol. 2017;24:183-7.

  22. Ramírez-González LR, Leonher-Ruezga KL, Plascencia-Posadas FJ, Jiménez- Gómez JA, López-Zamudio J, Fuentes-Orozco C. Adenocarcinoma mucoproductor in Meckel's diverticulum. Case report and review. Cir Cir. 2014;82(2):200-5.

  23. Marruste M, Rajaste G, Kase K. Torsion of Mechel´s diverticulum as a cause of small bowell obstruction: A case report. World J Gastrointest Surg. 2014;6(10):204-7.

  24. Xanthis A, Hakeen A, Safranek P. Laparoscopic management of terminal ileal volvulus caused by Meckel´s Diverticulum. Ann R Coll Surg Engl. 2015;97:e47-e49.

  25. Meza izquierdo O, Ferrer Robaina H, Pelegrinos Reyes R, Travieso Peña G, Díaz Fonseca A. Oclusión intestinal por hernia de Littré. Rev Cubana Cir [online]. 2016[citado 2018-03-16];55(3):259-64. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034- 74932016000300008&lng=es&nrm=iso ISSN 1561-2945.

  26. Kim KH, Kang KA, Lim JH, Lee KG, Kwon TJ. Inverted Meckel diverticulum as a lead point of small bowel intussusception: misinterpreting case as a lipoma. Clin Imaging. 2016;40(5):840-2.

  27. Fernández Santiesteban LlT, Goicolea Ramírez LR, Romanidy Cervantes C. Obstrucción intestinal por fitobezoar en un divertículo de Meckel. Rev Cubana Cir [Internet]. 2014[citado 2018 Mar 16];53(2):188-95. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034- 74932014000200009&lng=es

  28. Abizeid GA and Aref H. Case report: preoperatively diagnosed perforated Meckel’s diverticulum containing gastric and pancreatic-type mucosa. BMC Surgery. 2017; 17:36-9.

  29. Alves AG, Almeida M, Malheiro L, Costa-Maia J. Meckel’s diverticulum perforation by a fish bone: A case report. International Journal of Surgery Case Reports. 2016;28:237–40.

  30. Lorenzen AW, O’Dorisio TM, Howe JR. Neuroendocrine tumors arising in Meckel’s diverticula: frequency of advanced disease warrants aggressive management. Journal of gastrointestinal surgery: official journal of the Society for Surgery of the Alimentary Tract. 2013;17:1084-91.

  31. Sugezawa K, Saito H, Kono Y, Murakami Y, Shishido Y, Kuroda H et al. Neuroendocrine tumor Arising From Mecdel´s Diverticulum Unexpectedly Diagnosed After Diverticulectomy and in Which Multiple Lymph Node Metastases Were Found after Reoperation: A Case Report. Yonago Acta Medica. 2017;60:251–4.

  32. Mariusz C, Anna S-C, Tadeusz D, Dawid J, Michał J, Dariusz J. A massive bleeding from a gastrointestinal stromal tumor of a Meckel’s diverticulum. Srp Arh Celok Lek. 2016;144(3-4):219–21.

  33. Maia DS, Ferreira Junior M, Viegas RG, Silva EE, Oliveira P de T, et al. Bowel obstruction in Meckel diverticulum. Arq Bras Cir Dig. 2013;26(3):244–5.

  34. Marwah S, Singla P, Marwah N, Gupta S, Singh VP. Ileal stricture following Meckel's diverticulitis: a rare cause of intestinal obstruction. Clin J Gastroenterol. 2016;9(3):118-23.

  35. Pandove PK, Moudgil A, Pandove M, Chandrashekhar A, Sharda D, Sharda VK. Internat J of Surg Case Rep Meckel’s diverticulum mesentery along with its band forming a hernial sac: A rare case of internal herniation. 2015;10:17–9.

  36. Erol V, Yoldas T, Cin S, Çalıs C, Kan E, Akgün M. Complicated Meckel's diverticulum and therapeutic management, Ulus. Cerrahi Derg. 2013;29:63-66.




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