Meckel's diverticulum (MD) is a true congenital diverticulum that is remnant by incomplete obliteration of the omphalomesenteric duct. It is the most common congenital anomaly of the gastrointestinal tract, with an estimated prevalence of 2% (0.3% to 3% in autopsy studies). About 90% of MD occurs within 100 cm of the ileocecal valve. A primary malignant tumor arising within an MD is extremely uncommon. Malignancies are reported to account for only 0.5% to 3.2% of the complications. Carcinoids are the most common malignant tumors occurring in MD. Adenocarcinomas are extremely uncommon and very poor prognosis has been reported. We report a case of radiographically diagnosed chronic inflammatory mass caused by adenocarcinoma arising from MD in the ileum with malrotation of the midgut incidentally discovered at exploration.
Adenocarcinoma ; Autopsy ; Carcinoid Tumor ; Diverticulum ; Gastrointestinal Tract ; Ileocecal Valve ; Ileum ; Meckel Diverticulum ; Prevalence ; Prognosis ; Vitelline Duct

No abstract available.
Ileum*

No abstract available.
Ileum*

Meckel's diverticulum is a remnant of the vitelline duct located in the distal ileum, and it is the most common cause of small bowel bleeding in patients who are under the age of 25 years. The ectopic gastric mucosa in Meckel's diverticulum causes ulceration and acute gastrointestinal bleeding. Capsule endoscopy is now a valuable tool for diagnosing obscure gastrointestinal bleeding. However, the identification of a Meckel's diverticulum by wireless capsule endoscopy has rarely been reported on. An 18-year-old man was admitted for recurrent melena and anemia. He underwent a small bowel series that showed a jejunal diverticulum, and capsule endoscopy then revealed a jejunal diverticulum with multiple ulcerations. After 2 months, he had fresh hematochezia and so he underwent small bowel segemental resection that included the jejunal diverticulum. The operation revealed Meckels' diverticulum at 180 cm distant from the ileocecal valve at the mesenteric side. We report here on a case of bleeding Meckel's diverticulum that was diagnosed by wireless capsule endoscopy, and we include a review of the relevant literature.
Adolescent ; Anemia ; Capsule Endoscopy* ; Diverticulum ; Gastric Mucosa ; Gastrointestinal Hemorrhage ; Hemorrhage* ; Humans ; Ileocecal Valve ; Ileum ; Meckel Diverticulum ; Melena ; Ulcer ; Vitelline Duct

Meckel's diverticulum is a remnant of the vitelline duct located in the distal ileum, and it is the most common cause of small bowel bleeding in patients who are under the age of 25 years. The ectopic gastric mucosa in Meckel's diverticulum causes ulceration and acute gastrointestinal bleeding. Capsule endoscopy is now a valuable tool for diagnosing obscure gastrointestinal bleeding. However, the identification of a Meckel's diverticulum by wireless capsule endoscopy has rarely been reported on. An 18-year-old man was admitted for recurrent melena and anemia. He underwent a small bowel series that showed a jejunal diverticulum, and capsule endoscopy then revealed a jejunal diverticulum with multiple ulcerations. After 2 months, he had fresh hematochezia and so he underwent small bowel segemental resection that included the jejunal diverticulum. The operation revealed Meckels' diverticulum at 180 cm distant from the ileocecal valve at the mesenteric side. We report here on a case of bleeding Meckel's diverticulum that was diagnosed by wireless capsule endoscopy, and we include a review of the relevant literature.
Adolescent ; Anemia ; Capsule Endoscopy* ; Diverticulum ; Gastric Mucosa ; Gastrointestinal Hemorrhage ; Hemorrhage* ; Humans ; Ileocecal Valve ; Ileum ; Meckel Diverticulum ; Melena ; Ulcer ; Vitelline Duct

Meckel diverticulum is the most common congenital anomaly of the gastrointestinal system. Although it is commonly asymptomatic in adults, Meckel diverticulum can lead to intussusception, volvulus, inflammatory adhesions, or an internal hernia. However, small bowel obstruction due to a mesodiverticular band of Meckel diverticulum is rare. We report a case of a 24-year-old man who complained of abdominal pain and vomiting caused by recurrent small bowel obstruction. He had undergone no previous abdominal surgery. Abdominal computed tomography revealed a transition point at the mid-to-distal ileum. To identify the cause of the obstruction, we performed single-balloon enteroscopy, which revealed extrinsic compression at the proximal ileum 100 cm from the ileocecal valve. After marking the obstruction site, subsequent laparoscopy revealed a Meckel diverticulum with a mesodiverticular band, which entrapped a bowel loop and caused the recurrent small bowel obstruction. The patient was treated successfully with laparoscopic diverticulectomy.
Abdominal Pain ; Adult ; Hernia ; Humans ; Ileocecal Valve ; Ileum ; Intestinal Obstruction ; Intestinal Volvulus ; Intussusception ; Laparoscopy ; Meckel Diverticulum* ; Vomiting ; Young Adult

Adult intussusception is rare involving of only 1% of the causes of bowel obstruction. We report a case of a 39-year-old female with intussusceptions due to inverted Meckel's diverticulum. She visited our hospital for diffuse abdominal pain during 1 week and aggravated abdominal pain for 2 days. Vital signs were stable, and there was periumbilical tenderness. She had no history of abdominal operation. CT scan showed a 3.7x2.1 cm of fatty mass with focal intussusception in the distal ileum. When the emergency operation was performed, the patient was found to be suffering from ileocolic intussusception. A manual reduction of intussusception showed inverted Meckel's deverticulum at 65 cm proximal to the ileocecal valve, and the segmental resection of small bowel including a Meckel's diverticulum was performed. Pathologic examination revealed a Meckel's diverticulum containing a 0.6x0.6 cm sized aberrant pancreas.
Abdominal Pain ; Adult ; Emergencies ; Female ; Humans ; Ileocecal Valve ; Ileum ; Intussusception ; Meckel Diverticulum ; Pancreas ; Stress, Psychological ; Vital Signs

Intussusception is a frequent cause of bowel obstruction in the first five years of life and it is one of the most common surgical emergencies in infancy and early childhood. The age of five months child was administered in Department of Pediatrics of Chunchon Sacred Heart Hospital. His main symptoms were vomiting and high fever for three days. Abdominal sonography, air reduction and abdominal computerized tomography (CT) were performed and the conclusion of these study was intussusception due to cyst mass lesion; duplication cyst, mesenteric cyst or Meckel's diverticulum. He was transferred for operation. We had performed laparotomy for reduction of the intussusception. Operative findings revealed ileocolic type of intussusception due to cystic tumor on ileocecal valve that was invaginated into the cecum, and hyperplasia of the Peyer's patch were seen. But we failed manual reduction because of the tumor in the ileocecal area. So we had performed partial resection of the ileocecum. Diverticulum of the ileum was confirmed by pathologic examination. We experienced unusual cause of the intussusception. So we report this case with a review of the literatures.
Cecum ; Child ; Diverticulum* ; Emergencies ; Fever ; Gangwon-do ; Heart ; Humans ; Hyperplasia ; Ileocecal Valve ; Ileum ; Intussusception* ; Laparotomy ; Meckel Diverticulum ; Mesenteric Cyst ; Pediatrics ; Vomiting

Meckel's diverticulum is an embryologic derivative of the omphalomesenteric duct and the most commonly encountered congenital anomaly of the gastrointestinal tract, affecting 1% to 2% of the general population. Although this prevalence is relatively low, Meckel's diverticulum is occasionally encountered as an incidental identification during abdominal exploration and can be associated with several life-threatening disease states, such as massive intestinal bleeding, intestinal obstruction, or on rare occasion, perforation. The management of a Meckel's diverticulum found incidentally on laparotomy is controversial because the rate of complications developing from the diverticulum remains uncertain. The data in this report are based on 18 cases of Meckel's diverticulum which were treated at the Department of Surgery, InJe University Sanggye Paik Hospital, during the 7 years between January 1990 and December 1996. The results are as follows: 1) The overall sex ratio of males to females was 5 : 1 and in the symptomatic group, the ratio was 6 : 1. 2) Ninety percent of the patients were under 40 years of age, and 56% were under 10. 3) The diverticula were located from 20 cm to 100 cm proximal to the ileocecal valve, and the average range was 53 cm from the ileocecal valve. Fifteen cases were located at the antimesenteric border, and 3 cases at the mesenteric border of the ileum. 4) The lengths of the diverticula ranged from 1cm to 6cm, and the diameters ranged from 0.5 cm to 4.5 cm. 5) Appendicitis and intestinal obstruction were the most frequent preoperative diagnoses in the symptomatic group. 6) The common complications were intestinal obstruction and inflammation. 7) Heterotopic tissues were found in three patients and all of them were ectopic gastric mucosa. 8) The treatment was a diverticulectomy or a segmental resection of the involved bowel. 9) Postoperative complications were found in three of the asymptomatic group: two early intestinal obstructions and one wound infection.
Appendicitis ; Choristoma ; Diagnosis ; Diverticulum ; Female ; Gastric Mucosa ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Ileocecal Valve ; Ileum ; Inflammation ; Intestinal Obstruction ; Laparotomy ; Male ; Meckel Diverticulum* ; Postoperative Complications ; Prevalence ; Sex Ratio ; Vitelline Duct ; Wound Infection

Alimentary tract duplication is a rare congenital anomaly which may involve any part of the alimentary tract extending from stomach to rectum. Clinical presentation may mimic an inflamed appendix as described in this case. A 9-year-old boy with a clinical diagnosis of perforated appendix was noted to have a normal appendix intra-operatively. On further search for an underlying pathology, a gangrenous ileal duplication was discovered. En-bloc resection with primary bowel anastomosis was done. Histopathology report revealed a gangrenous small bowel duplication. We discuss the preoperative diagnostic dilemma and management options in approaching this rare entity.
Gangrene ; Ileum