Unusual roentgenologic manifestations of Meckel's diverticulum

Fistulae involving the appendix: a systematic review of the literature

BACKGROUND

The appendix has a unique place in surgical history. Although the first ever appendicectomy involved a fistula to the skin, fistulae involving the appendix remain uncommon and can lead to unique surgical considerations.

METHODS

A systematic review of the literature was performed for case reports of appendiceal fistulae. We excluded cases in which the patient had a history of appendicectomy. Cases were categorized by site and aetiology, with information regarding relative frequency and demographics obtained.

RESULTS

A total of 301 case reports of fistula involving the appendix were found. The most common sites of these fistulae were to the bladder (148 cases), skin (40 cases), vasculature (19 cases), umbilicus (16 cases) and to the gastrointestinal tract. The most common aetiology in sub-analysis was appendicitis alone (150 cases), with less common causes including appendiceal adenocarcinoma (32 cases) and congenital abnormalities (18 cases). There were significantly more appendiceal fistulae in males than in females, with a ratio of 1.7:1. In patients with appendiceal adenocarcinoma as a cause for fistula, there were significantly more females than males with a ratio of 2.3:1.

CONCLUSION

In conducting a systematic review of case reports of fistulae involving the appendix, we identified 301 unique case reports, with a range of different sites and aetiologies.

Giant Meckel diverticulum with enteroliths: a case report of a patient presenting with low back and episodic right lower quadrant pain

OBJECTIVES

The purpose of this case report is to describe a patient who presented with low back pain and episodic right lower quadrant pain who had a long-standing giant Meckel diverticulum with enteroliths.

CLINICAL FEATURES

A 49-year-old woman presented to a chiropractic clinic with low back pain and history of intermittent right lower quadrant pain. Lumbar radiography demonstrated calcifications in the pelvic basin that changed position with changes in patient posture. The patient was referred to an abdominal surgeon for consultation and management.

INTERVENTION AND OUTCOME

Computed tomography identified calcifications in the small bowel in the region of the ileocecal valve. The patient underwent prophylactic diverticulectomy with no complications. Gross pathology revealed a giant Meckel diverticulum measuring 24 inches (60.9 cm) containing 6 enteroliths.

CONCLUSIONS

A timely diagnosis resulted in a favorable surgical outcome for this patient with long-standing giant Meckel diverticulum and enteroliths.

Giant Meckel diverticulum containing enteroliths diagnosed by computed tomography and sonography

A 23-year-old male patient with giant Meckel diverticulum containing enteroliths is presented. Computed tomography (CT) and sonography were useful for correctly suggesting the diagnosis. The unique manifestations of this rare lesion are described.

Unusual presentation of Meckel's diverticulum

Images

Detection of intestinal diverticula by double-contrast small bowel enema: differentiation from other intestinal diverticula

This report documents the roentgenographic diagnosis of diverticula in the jejunum and ileum. The experience has been gained from 7 Meckel's and 8 other diverticula shown by the small bowel enema in 400 patients. Diverticulum detection rate by this technique approaches the incidence in autopsy series. Differentiation between Meckel's, acquired, and pseudodiverticula by means of specific radiologic criteria is discussed.