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Alkhamisy A, Douba Z, Jawish H, Helaly H, Alkhalaf Y, Alhaj A, Morjan M. Symptomatic mesenteric Meckel's diverticulum in a toddler. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2021. [DOI: 10.1016/j.epsc.2021.101978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Koetter P, Cochran E, Tsai AY. Mesenteric Meckel's diverticulum in a 17 month old female. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2021. [DOI: 10.1016/j.epsc.2021.101835] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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McGrath AK, Suliman F, Thin N, Rohatgi A. Adult intussusception associated with mesenteric Meckel's diverticulum and antimesenteric ileal polyp. BMJ Case Rep 2019; 12:e230612. [PMID: 31537591 PMCID: PMC6754700 DOI: 10.1136/bcr-2019-230612] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2019] [Indexed: 11/04/2022] Open
Abstract
Meckel's diverticulum is the most common congenital abnormality affecting the gastrointestinal tract, affecting 4% of the general population. It is classically located on the antimesenteric border of the ileum within 100 cm of the ileocaecal valve. Complications may include haemorrhage, bowel obstruction, diverticulitis, perforation and malignancy. This report explores the case of intussusception in an adult, in association with a mesenteric Meckel's diverticulum and adjacent benign polyp. A 40-year-old man presented with acute abdominal pain, affecting the central abdomen and both flanks. CT imaging revealed small bowel intussusception, with either a Meckel's diverticulum or polyp acting as a lead point. Intraoperatively, the intussusception had already resolved; however, an inflamed outpouching was identified on the mesenteric border of the ileum, with a firm mass palpable within the bowel lumen. A 70 mm small bowel resection and primary anastomosis were performed. Histopathological analysis confirmed an inflamed Meckel's diverticulum as well as an adjacent diverticulum comprising a benign polyp.
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Affiliation(s)
- Adrian K McGrath
- Department of General Surgery, Whipps Cross University Hospital, London, UK
| | - Fatimah Suliman
- Department of General Surgery, Whipps Cross University Hospital, London, UK
| | - Noel Thin
- Department of General Surgery, Whipps Cross University Hospital, London, UK
| | - Ashish Rohatgi
- Department of General Surgery, Whipps Cross University Hospital, London, UK
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Torsion of Atypical Meckel's Diverticulum Treated by Laparoscopic-Assisted Surgery. Case Rep Med 2017; 2017:4514829. [PMID: 28785284 PMCID: PMC5530436 DOI: 10.1155/2017/4514829] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Accepted: 06/15/2017] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Meckel's diverticulum (MD) is the most common congenital anomaly of the intestine, with an incidence of 2~4%. Of those, only 2% of patients with MD are symptomatic. Torsion of MD is extremely rare, and only a dozen cases have been previously reported. CASE REPORT The patient was a 49-year-old male who presented to our emergency room with a chief complaint of lower abdominal pain. Computed tomography imaging revealed an irregular polycystic mass connected to the small intestine that measured 7.5 cm in a diameter. A laparoscopic-assisted partial resection of the jejunum was performed. The lesion was found to have caused torsion and was located 130 cm from the ileocecal valve. The specimen was polycystic in appearance and showed communicating links with the submucosal layer of jejunum but not with the lumen. The pathological diagnosis was a torsion of an atypical presentation of MD. CONCLUSION This case was different from typical cases of MD in that it was located on significantly oral side and had the appearance of polycystic morphology.
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Hamza AR, Bicaj BX, Kurshumliu FI, Zejnullahu VA, Sada FE, Krasniqi AS. Mesenteric Meckel's diverticulum or intestinal duplication cyst: A case report with review of literature. Int J Surg Case Rep 2016; 26:50-2. [PMID: 27449764 PMCID: PMC4963246 DOI: 10.1016/j.ijscr.2016.06.043] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 06/27/2016] [Accepted: 06/27/2016] [Indexed: 02/07/2023] Open
Abstract
Mesenteric Meckel’s diverticulum and intestinal duplication cyst both are congenital anomaly of the gastrointestinal tract. Preoperative diagnosis is very hard to establish even after Surgery. Ectopic gastric or pancreatic mucosa can be found in both these pathologies. Surgical treatment is gold standard of both because of their complictions.
Introduction A Meckel’s diverticulum (MD) is the most common congenital anomaly of the gastrointestinal (GI) tract. They arise from the middle-to-distal ileum. Contrary to MD, intestinal duplication cyst (IDC) is uncommon congenital anomaly of GI, but can occur anywhere from the tongue to the anus. Presentation of case Here we report an 18-year-old male who presented to the department of abdominal surgery with chronic abdominal pain, frequent vomiting and mild abdominal distension. Following radiological investigation, a laparotomy was performed with the preoperative diagnosis of a mesenteric cyst. Intraoperativelly it became apparent that the cystic mass was on the mesenteric aspect of the small bowel without intestinal communication. Resection of the cyst was performed. Histological examination of the specimen revealed the presence of gastric tissue, which resembles MD. Although, the exact diagnosis of this cystic mass is ambiguous between MD and IDC, because of similar clinical signs, their complications and presence of gastric mucosa, however surgical treatment is gold standard of both. Conclusion This case report underlines the necessity of how to differentiate between MD and IDC, although, surgical management is recommended for both.
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Affiliation(s)
- Astrit R Hamza
- Department of Abdominal Surgery, Clinic of Surgery, University Clinical Centre of Kosova (UCCK), 10000, Prishtina, Kosovo; Faculty of Medicine, University of Prishtina, 10000, Prishtina, Kosovo
| | - Besnik X Bicaj
- Department of Abdominal Surgery, Clinic of Surgery, University Clinical Centre of Kosova (UCCK), 10000, Prishtina, Kosovo; Faculty of Medicine, University of Prishtina, 10000, Prishtina, Kosovo
| | - Fisnik I Kurshumliu
- Faculty of Medicine, University of Prishtina, 10000, Prishtina, Kosovo; Institute of Anatomic Pathology, University Clinical Centre of Kosova (UCCK), 10000, Prishtina, Kosovo
| | - Valon A Zejnullahu
- Department of Abdominal Surgery, Clinic of Surgery, University Clinical Centre of Kosova (UCCK), 10000, Prishtina, Kosovo
| | - Fatos E Sada
- Faculty of Medicine, University of Prishtina, 10000, Prishtina, Kosovo; Department of Anesthesiology and Reanimation, University Clinical Centre of Kosova (UCCK), 10000, Prishtina, Kosovo
| | - Avdyl S Krasniqi
- Department of Abdominal Surgery, Clinic of Surgery, University Clinical Centre of Kosova (UCCK), 10000, Prishtina, Kosovo; Faculty of Medicine, University of Prishtina, 10000, Prishtina, Kosovo.
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Abbas SH, Akbari K, Mason J, Booth M. Mesenteric Meckel's diverticulum: an unusual cause of small bowel intussusception. BMJ Case Rep 2016; 2016:bcr-2016-214830. [PMID: 27060074 DOI: 10.1136/bcr-2016-214830] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Meckel's diverticulum (MD) is the commonest congenital anomaly of the small intestine, affecting 1-4% of the population. Cardinal features emphasise an antimesenteric location two feet proximal to the ileocaecal valve, with a separate mesenteric blood supply and involvement of all layers of the small intestine. However, reports of MD arising from the mesenteric border of the small intestine are rare in the surgical literature. This report examines the case of a 45-year-old woman presenting with a 6-month history of episodic central abdominal pain and microcytic anaemia who underwent an elective diagnostic laparoscopy as initial CT findings were inconclusive. Intraoperatively, she was found to have small bowel intussusception approximately 40 cm proximal to the ileocaecal valve. Macroscopic examination of the resected small bowel segment revealed a mesenteric outpouching that was confirmed as mesenteric MD on histopathological analysis. Postoperatively, the patient recovered with no surgical complications and full symptom resolution.
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Affiliation(s)
| | | | - John Mason
- Royal Berkshire Hospital, Reading, Berkshire, UK
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Nussbaum DP, Bhattacharya SD, Jiang X, Cardona DM, Strickler JH, Blazer DG. Gastroesophageal Heterotopia and HER2/neu Overexpression in an Adenocarcinoma Arising From a Small Bowel Duplication. Arch Pathol Lab Med 2014; 138:428-31. [DOI: 10.5858/arpa.2012-0523-cr] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Small bowel duplications are congenital structures commonly lined by heterotopic gastric or pancreatic mucosa. Though benign in children, small bowel duplications have the potential for malignant degeneration in adulthood. Here, we present the first reported case of metastatic adenocarcinoma arising from a small bowel duplication lined by gastroesophageal mucosa. The cancer demonstrated overexpression of the HER2/neu oncoprotein and amplification of the HER2/neu gene. This represents the only report of HER2 overexpression in this type of lesion. The patient is being treated with traditional chemotherapeutic agents in addition to monoclonal antibody therapy directed at the HER2 protein, and has demonstrated a clinical benefit from treatment. This case demonstrates that the anatomic location of a mass may be distinct from its biological origin, and this difference may have important practical implications for diagnostic testing and treatment.
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Affiliation(s)
- Daniel P. Nussbaum
- From the Departments of Surgery (Drs. Nussbaum, Bhattacharya, and Blazer), Pathology (Drs. Jiang and Cardona), and Medicine (Dr. Strickler), Duke University, Durham, North Carolina
| | - Syamal D. Bhattacharya
- From the Departments of Surgery (Drs. Nussbaum, Bhattacharya, and Blazer), Pathology (Drs. Jiang and Cardona), and Medicine (Dr. Strickler), Duke University, Durham, North Carolina
| | - Xiaoyin Jiang
- From the Departments of Surgery (Drs. Nussbaum, Bhattacharya, and Blazer), Pathology (Drs. Jiang and Cardona), and Medicine (Dr. Strickler), Duke University, Durham, North Carolina
| | - Diana M. Cardona
- From the Departments of Surgery (Drs. Nussbaum, Bhattacharya, and Blazer), Pathology (Drs. Jiang and Cardona), and Medicine (Dr. Strickler), Duke University, Durham, North Carolina
| | - John H. Strickler
- From the Departments of Surgery (Drs. Nussbaum, Bhattacharya, and Blazer), Pathology (Drs. Jiang and Cardona), and Medicine (Dr. Strickler), Duke University, Durham, North Carolina
| | - Dan G. Blazer
- From the Departments of Surgery (Drs. Nussbaum, Bhattacharya, and Blazer), Pathology (Drs. Jiang and Cardona), and Medicine (Dr. Strickler), Duke University, Durham, North Carolina
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