Midgut Abnormalities

A Case of Endometrial Tissue Containing Meckel's Diverticulum in an Adult

A Meckel's diverticulum is one of the most common congenital causes of small bowel obstruction. The lack of a more common gastric-containing tissue and older age of symptom onset can lead to difficulties with preoperative diagnosis. This case demonstrates an adult with chronic abdominal pain with recurrent small bowel obstruction that was found to be a rare ectopic endometrial tissue containing a Meckel's diverticulum following a diagnostic laparotomy. The barriers to diagnostics and factors affecting the age of onset are discussed with a focus on demonstrating the importance of surgical intervention for small bowel obstruction due to a Meckel's diverticulum and on the significance of a rare histological finding.

Small Bowel Congenital Anomalies: a Review and Update

The small intestine is a complex organ system that is vital to the life of the individual. There are a number of congenital anomalies that occur and present most commonly in infancy; however, some may not present until adulthood. Most congenital anomalies of the small intestine will present with obstructive symptoms while some may present with vomiting, abdominal pain, and/or gastrointestinal bleeding. Various radiologic procedures can aid in the diagnosis of these lesions that vary depending on the particular anomaly. Definitive therapy for these congenial anomalies is surgical, and in some cases, surgery needs to be performed urgently. The overall prognosis of congenital anomalies of the small intestine is very good and has improved with improved medical management and the advent of newer surgical modalities. The congenital anomalies of the small intestine reviewed in this article include malrotation, Meckel's diverticulum, duodenal web, duodenal atresia, jejunoileal atresia, and duplications.

Intestinal nonrotation in an adolescent

We present the case of a 17-year-old adolescent girl with nonrotation of the intestine. This rare entity results from an error in rotation that occurs during the second stage of embryonic alimentary tract development. Nonrotation often goes undiagnosed for years and is frequently a coincidental finding during the evaluation of another process. Computed tomography can be helpful in making the diagnosis and may show an inverse relationship between the superior mesenteric artery and vein and may also reveal an abnormally located bowel.

The crying infant

Infants with the chief complaint of crying can present a diagnostic dilemma to the health care provider. This article discusses the differential diagnosis and management of the crying infant.