1.Ileo-Ileal Intussusception with Meckel Diverticulum in a Filipino adolescent
John Nicholas Pantoja ; Manuelito Madrid
Philippine Journal of Pathology 2023;8(2):53-56
Intussusception refers to the invagination (telescoping) of a part of the intestine into itself. Intussusception occurs primarily in infants and toddlers.1 The peak incidence is between 4 and 36 months of age, and it is the most common cause of intestinal obstruction in this age group. 2 Approximately 1 percent of cases are in infants younger than three months, 30 percent between 3 and 12 months, 20 percent between one and two years, 25 percent between two and three years, and 10 percent between three and four years.3 Although intussusception is most common in infants and young children, it is important to consider this diagnosis in children outside this age range. Approximately 10 percent of cases are in children over five years, and 3 to 4 percent in those over 10 years.3,4 We share here images from an actual case of a 15-year-old Filipino male with an ileo-ileal intussusception that is beyond the typical age range, with an incidental finding of an intraluminal mass that was histomorphologically diagnosed as Meckel’s diverticulum (MD). The diagnosis of intussusception is relatively rare in the patient’s age and the diagnosis of MD in the presence of intussusception is sparsely reported in the Philippines.
Intussusception refers to the invagination (telescoping) of a part of the intestine into itself. Intussusception occurs primarily in infants and toddlers.1 The peak incidence is between 4 and 36 months of age, and it is the most common cause of intestinal obstruction in this age group. 2 Approximately 1 percent of cases are in infants younger than three months, 30 percent between 3 and 12 months, 20 percent between one and two years, 25 percent between two and three years, and 10 percent between three and four years.3 Although intussusception is most common in infants and young children, it is important to consider this diagnosis in children outside this age range. Approximately 10 percent of cases are in children over five years, and 3 to 4 percent in those over 10 years.3,4 We share here images from an actual case of a 15-year-old Filipino male with an ileo-ileal intussusception that is beyond the typical age range, with an incidental finding of an intraluminal mass that was histomorphologically diagnosed as Meckel’s diverticulum (MD). The diagnosis of intussusception is relatively rare in the patient’s age and the diagnosis of MD in the presence of intussusception is sparsely reported in the Philippines.
Meckel Diverticulum
;
Strabismus
;
Adolescent
3.Value of capsule endoscopy in children with small intestinal diseases with hematochezia as the chief complaint.
Jie WU ; Ai-Juan XUE ; Zi-Fei TANG ; Yu-Huan WANG ; Ying HUANG
Chinese Journal of Contemporary Pediatrics 2020;22(9):1007-1010
OBJECTIVE:
To evaluate the value of capsule endoscopy in children with small intestinal diseases with hematochezia as the chief complaint.
METHODS:
A retrospective analysis was performed on the clinical data and capsule endoscopy findings of 93 children with hematochezia who were admitted to Children's Hospital of Fudan University from May 2015 to January 2019 and underwent capsule endoscopy. According to the capsule endoscopy findings of the jejunum and the ileum, they were divided into a positive lesion group with 39 patients and a negative lesion group with 54 patients. Related clinical data and the features of lesion on capsule endoscopy were analyzed for the two groups.
RESULTS:
There were no significant differences in age, sex, duration of capsule endoscopy, gastric transit time, and small intestinal transit time between the positive lesion and negative lesion groups (P>0.05). The positive lesion group had a significantly lower level of hemoglobin than the negative lesion group (P<0.05). Hemoglobin level was negatively correlated with the rate of positive lesions on capsule endoscopy (r=-0.342, P=0.001). Among the 39 patients with positive lesions on capsule endoscopy, the detection of Meckel's diverticulum was the highest (41%), followed by inflammatory bowel disease (21%).
CONCLUSIONS
Capsule endoscopy has a certain value in detecting small intestinal diseases, especially diseases in the jejunum and the ileum, in children with lower gastrointestinal hemorrhage.
Capsule Endoscopy
;
Child
;
Gastrointestinal Hemorrhage
;
Humans
;
Intestinal Diseases
;
Jejunum
;
Meckel Diverticulum
;
Retrospective Studies
4.Rapidly Progressive Small Bowel Necrosis in a Previously Healthy Child without Proven Mechanical Obstruction
Hyun Hee KIM ; Hyungoo KANG ; Chul Hee PARK ; Yu Jin KWON ; Euna JUNG ; Misun LIM
Pediatric Gastroenterology, Hepatology & Nutrition 2019;22(3):291-297
Bowel ischemia is a life-threatening surgical emergency. We report a case of rapidly progressive bowel necrosis in a previously healthy child without proven mechanical small bowel obstruction. The definite diagnosis was established at the time of an exploratory operation. Of note, imaging studies and even a laparotomy did not reveal any evidence of acute appendicitis or mechanical obstruction such as intussusception or Meckel's diverticulum. During hospitalization, since we could not rule out surgical abdomen after inconclusive image findings, we closely followed the patient and repeated physical examinations carefully. Eventually surgical exploration was performed based on changes in clinical condition, which proved to be the right decision for the patient. We propose that in children with suspected strangulation of small bowel obstruction, especially when imaging findings do not provide a conclusive diagnosis, the timely exploratory surgical approach ought to be chosen based on carefully observed clinical findings and other evaluations.
Abdomen
;
Appendicitis
;
Child
;
Diagnosis
;
Emergencies
;
Hospitalization
;
Humans
;
Intestine, Small
;
Intussusception
;
Ischemia
;
Laparotomy
;
Meckel Diverticulum
;
Mesenteric Ischemia
;
Necrosis
;
Physical Examination
5.Meckel's Diverticulum Diagnosed in a Child with Suspected Small Bowel Crohn's Disease.
Hyun Sik KANG ; Jeong Sub LEE ; Chang Rim HYUN ; In Ho JUNG ; Ki Soo KANG
Pediatric Gastroenterology, Hepatology & Nutrition 2019;22(1):98-104
We report a rare case of Meckel's diverticulum in a boy who initially presented with chronic iron deficiency anemia (IDA) without any history of gastrointestinal (GI) bleeding at 8 years-old. Isolated small bowel Crohn's disease was suspected based on findings of small bowel ulcers on capsule endoscopy. At four years from initial presentation, he developed massive GI bleeding. Abdominal computed tomographic angiography and small bowel series revealed findings suggestive of Meckel's diverticulum. Meckel's diverticulum should be suspected in children with unexplained chronic IDA even in the absence of prominent GI bleeding and negative findings on repetitive Meckel's scans. Moreover, Meckel's diverticulum should be included in the differential diagnosis of isolated small bowel Crohn's disease when the disease is limited to a short segment of the distal small bowel, as ulcers and inflammation may result as a consequence of acid secreted from adjacent heterotopic gastric mucosa constituting the Meckel's diverticulum.
Anemia, Iron-Deficiency
;
Angiography
;
Capsule Endoscopy
;
Child*
;
Crohn Disease*
;
Diagnosis, Differential
;
Gastric Mucosa
;
Hemorrhage
;
Humans
;
Inflammation
;
Male
;
Meckel Diverticulum*
;
Ulcer
6.Diagnosis of Meckel's Diverticulum Using Colon Capsule Endoscopy for Small Bowel Investigation.
Lidia CIOBANU ; Oliviu PASCU ; Marcel TANȚĂU
Clinical Endoscopy 2018;51(4):395-396
No abstract available.
Capsule Endoscopy*
;
Colon*
;
Diagnosis*
;
Meckel Diverticulum*
7.Adult Intussusception Caused by Inverted Meckel's Diverticulum Containing Mesenteric Heterotopic Pancreas and Smooth Muscle Bundles.
Journal of Pathology and Translational Medicine 2017;51(1):96-98
No abstract available.
Adult*
;
Humans
;
Intussusception*
;
Meckel Diverticulum*
;
Muscle, Smooth*
;
Pancreas*
8.Congenital Jejunal Diverticular Bleeding in a Young Adult.
Ji Yung LEE ; Jae Young JANG ; Min Je KIM ; Tae In LEE ; Jung Wook KIM ; Young Woon CHANG
Clinical Endoscopy 2017;50(5):495-499
Diverticular bleeding of the small bowel is rare and occurs primarily in adults aged more than 60 years. In younger adults, Meckel's diverticulum, a true diverticulum that congenitally occurs in the distal ileum, is the most common cause of diverticular bleeding of the small bowel. Unlike Meckel's diverticula, other kinds of small bowel diverticula are not congenital and their incidence is related to age. Furthermore, congenital true diverticular bleeding of the jejunum in adults is very rare. We report the case of a 24-year-old man with subepithelial tumor-like lesion accompanied with obscure overt gastrointestinal bleeding. This lesion was initially suspected to be a subepithelial tumor based on radiologic tests and capsule endoscopy. He was finally diagnosed with a congenital true diverticulum in the jejunum with the appearance of a Meckel's diverticulum after surgical resection.
Adult
;
Capsule Endoscopy
;
Diverticulum
;
Gastrointestinal Hemorrhage
;
Hemorrhage*
;
Humans
;
Ileum
;
Incidence
;
Jejunum
;
Meckel Diverticulum
;
Neoplasms, Glandular and Epithelial
;
Young Adult*
9.Giant Duplication Cyst Presenting as a Discharging Umbilicus.
Ravi Kumar GARG ; Monika BAWA ; Katragadda Lakshmi NARASIMHA RAO
Pediatric Gastroenterology, Hepatology & Nutrition 2017;20(3):194-197
Alimentary tract duplication cysts are rare congenital anomalies, most commonly located in the ileum, but may present anywhere from mouth to anus.Clinically, they may be asymptomatic, incidentally diagnosed or may present with obstruction, volvulus, intussusception or gastrointestinal bleed. Here we report a case of a one year old male child presenting in gasping state and shock. Despite the initial strong suspicion of Meckel's diverticulum and tubercular abdomen, the final diagnosis remained elusive till exploratory laparotomy was performed which revealed a duplication cyst of ileum with perforation into the umbilicus. Duplication cyst should always be kept as a differential diagnosis so that early intervention can help in better management.
Abdomen
;
Ascites
;
Child
;
Diagnosis
;
Diagnosis, Differential
;
Early Intervention (Education)
;
Humans
;
Ileum
;
Intestinal Volvulus
;
Intussusception
;
Laparotomy
;
Male
;
Meckel Diverticulum
;
Mouth
;
Shock
;
Umbilicus*
10.Intestinal Duplication Cyst Misdiagnosed as Meckel's Diverticulum.
Yee-Suk KIM ; Dong-Ju KIM ; Seung-Uk BANG ; Jun-Jae PARK
Chinese Medical Journal 2016;129(2):235-236


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