PURPOSE: The diagnosis of Meckel's diverticulum is difficult and delayed because it presents with various clinical symptoms. We evaluated clinical, imaging and pathologic findings of Meckel's diverticulum to facilitate detection of Meckel's diverticulum in children. METHODS: Review of clinical, imaging, surgical and pathological findings in 10 children aged 7 days to 14 years with Meckel's diverticulum during an 8-year period, 1993-2001, at Ewha Womans University Hospital was undertaken. RESULTS: The male to female ratio was 2.3 : 1. The chief complaint was painless lower gastrointestinal(GI) bleeding; others were abdominal pain, abdominal distention and vomiting, in order of frequency. The diagonsis before surgery were Meckel's diverticulum in 5 patients, non-reducible intussusception in 3 patients and intestinal obstruction in 2 patients. The diverticulum was located between 35 cm to 70 cm proximal to the ileocecal valve. The length of the diverticulum ranged from 4 cm to 12 cm and 80% of it was within 5 cm. A Meckel scan(99mTc-pertechnetate scintigraphy) after cimetidine administration was done in 6 cases. All 5 cases that presented with lower GI bleeding had ectopic gastric mucosa confirmed on pathology. Out of 5 cases of ectopic gastric mucosa, only 4 cases were positive on the Meckel's scan. CONCLUSION: In cases of unexplained GI bleeding, obstruction, or inflammation diagnostic workup should be carried out to rule out Meckel's diverticulum. Laparoscopy, high resolution ultrasonography and computed tomography of the abdomen may be indicated in the assessment of pediatric patient with lower GI bleeding, especially in patients with suspected bleeding from Meckel's diverticulum showing negative Meckel's scan.
Abdomen ; Abdominal Pain ; Child ; Cimetidine ; Diagnosis ; Diverticulum ; Female ; Gastric Mucosa ; Hemorrhage ; Humans ; Ileocecal Valve ; Inflammation ; Intestinal Obstruction ; Intussusception ; Laparoscopy ; Male ; Meckel Diverticulum* ; Pathology ; Ultrasonography ; Vomiting

A 32-year-old man, who had no previous medical history, was hospitalized with 3-week duration of abdominal pain, fever, and watery diarrhea. Initial colonoscopy showed subepithelial hemorrhagic spots throughout the entire colon together with well-circumscribed ulcer around the ileocecal valve. Serologic test disclosed HIV-positive and repeated biopsies at ulcer base finally revealed that the patient had cytomegalovirus ulcer in ileocecal area.
AIDS-Related Opportunistic Infections/complications/*diagnosis ; Adult ; Colitis/complications/diagnosis/*virology ; Colonoscopy ; Cytomegalovirus Infections/complications/*diagnosis ; Humans ; Ileal Diseases/complications/pathology/*virology ; *Ileocecal Valve/pathology ; Male ; Ulcer/complications/pathology/*virology

No abstract available.
Arterial Occlusive Diseases/complications/*diagnosis/radiography ; Hemorrhage ; Humans ; Ileal Diseases/radiography/surgery ; Ileocecal Valve/blood supply ; Infarction/pathology/*surgery ; Male ; Mesenteric Artery, Superior/*radiography ; Middle Aged ; Thromboangiitis Obliterans/complications/*diagnosis ; Tomography, X-Ray Computed

A 7-year-old Thoroughbred horse was admitted to the Equine Hospital, Korea Racing Association with signs of colic. Based on the size of impactions, the clinical signs, the results of abdominal paracentesis and medical treatment, the prognosis was poor. The horse died 3 hours later following hopeless discharge. At necropsy, the caecum and large colon were fully filled with fecal contents and there was a rupture (10 cm in dia) in the latero- ventral caecum. The mucosa of the ileo-caecal and caeco- colic valves appeared to the hyperemic, edematous and ulcerous. There were many tapeworms in the affected mucosa. Histopathologically, lesions included hyperaemia, a deep necrotic inflammatory lesion and ulcers in the mucosa and submucosa of ileo-caecal and caeco-colic valves. One hundred thirty four faecal samples were obtained from 16 stables and submitted to parasitic examination. A total of 4 genera of eggs were recovered: Stongylus spp (82.1%), Anoplocephala perfoliata (10.5%), Bovicola equi (0.7%) and Parascaris equorum (1.5%). The major findings in this study are the presence of A perfoliata and its suspected association with the colic which led into an eventual caecal rupture. This study indicates the needs for an epidemiological survey of colic that is associated with Anoplocephala.
Animals ; Cecal Diseases/etiology/pathology/*veterinary ; Cestoda ; Cestode Infections/complications/pathology/*veterinary ; Colic/etiology/*veterinary ; Fatal Outcome ; Fecal Impaction/complications/parasitology/veterinary ; Feces/parasitology ; Horse Diseases/etiology/*parasitology/pathology ; Horses ; Ileocecal Valve/parasitology/pathology ; Intestinal Diseases, Parasitic/parasitology/pathology/*veterinary ; Intestinal Mucosa/parasitology/pathology ; Korea ; Parasite Egg Count/veterinary ; Prognosis ; Rupture, Spontaneous/pathology/veterinary

Antigens, CD20 ; metabolism ; CD5 Antigens ; metabolism ; Colonic Neoplasms ; complications ; metabolism ; pathology ; surgery ; Cyclin D1 ; metabolism ; Diagnosis, Differential ; Female ; Humans ; Ileal Diseases ; complications ; pathology ; surgery ; Ileocecal Valve ; Intestinal Neoplasms ; complications ; metabolism ; pathology ; surgery ; Intestinal Polyps ; complications ; metabolism ; pathology ; surgery ; Intussusception ; complications ; pathology ; surgery ; Leukemia, Lymphocytic, Chronic, B-Cell ; metabolism ; pathology ; Lymphoma, Mantle-Cell ; complications ; metabolism ; pathology ; surgery ; Middle Aged

Tuberculosis can occur anywhere in the gastrointestinal tract. However, anorectal tuberculosis has rarely been reported. A 46-years-old male presented with abdominal pain and perianal discharge of 30 years' duration. The patient had received operations for anal fistula and inflammation three times. Although he had been taking mesalazine for the past three years after being diagnosed with Crohn's disease, his symptoms persisted. Colonoscopy performed at our hospital revealed cicatricial change of ileocecal valve and diffuse ulcer scar with mild luminal narrowing of the ascending, transverse, and descending colon without active lesions. Multiple large irregular active ulcers were observed in the distal sigmoid and proximal rectum. An anal fistula opening with much yellowish discharge and background ulcer scar was observed in the anal canal. However, cobble-stone appearance and pseudopolyposis were not present. Therefore, we clinically diagnosed him as having intestinal tuberculosis with anal fistula and prescribed antituberculosis medications. Follow-up colonoscopy performed 3 months later showed much improved multiple large irregular ulcers in the distal sigmoid colon and proximal rectum along with completely resolved anal fistula without evidence of pus discharge.
Anal Canal ; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use ; Antitubercular Agents/therapeutic use ; Colon/pathology ; Colonoscopy ; Crohn Disease/diagnosis/drug therapy ; Diagnosis, Differential ; Fistula/*diagnosis/pathology ; Humans ; Ileocecal Valve/physiopathology ; Male ; Mesalamine/therapeutic use ; Middle Aged ; Protein C/analysis ; Tuberculosis, Gastrointestinal/*diagnosis/drug therapy