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PubMed1989

Adenocarcinoma in Meckel's diverticulum: case report and literature review.

A case of adenocarcinoma arising in Meckel's diverticulum in a 55 year old man is reported, and a brief review of the literature is presented. The patient developed low abdominal pain and showed elevation of serum carcinoembryonic antigen (CEA) level. The tumour was located in the apical portion of the diverticulum and extended into the mesenterium. Histologically, the tumour was a well-differentiated adenocarcinoma arising in the Meckel's diverticulum. Immunohistochemical study showed that malignant cells were positive for CEA. The noteworthy feature of this case is the pre-operative elevation of serum CEA level and the immunohistochemical demonstration of CEA in the cancer cells.

Adenocarcinoma↗
PubMed1994

Use of surgical stapling device in excision of pharyngeal diverticulum.

Pharyngeal diverticulum (Zenker's diverticulum, hypopharyngeal pouch) is an outpouching of pharyngeal mucosa through a triangular area of weakness between the lower oblique fibres of the inferior constrictor muscle and cricopharyngeus called Killian's dehiscence. Prescribed treatment in large pouches is excision of the diverticulum with or without cricopharyngeal myotomy. Experience of closure of the oesophageal defect with an automatic stapling device is presented in nine cases of pharyngeal diverticula. Previous reports describing this technique have included substantial delays in the resumption of oral intake and prolonged hospitalization. It is shown that these delays are unnecessary.

Aged↗
PubMed1980

Urethral diverticulum in females.

Thirteen cases of urethral diverticulum in females are reported. Symptoms were non-specific. Two cases presented with suppuration in previously undiagnosed diverticula. The most important physical sign was palpation of the sac on vaginal examination. Micturating cystourethrography was the most useful investigation. An association with carcinoma makes excision mandatory and in 10 cases this was performed by a vaginal approach. A laterally based flap incision is described which was used in 7 cases without complication. In one case the diverticulum recurred after 5 years and was removed in the same way. Two cases that presented with suppuration were treated by incision and drainage: in one the diverticulum re-formed and the other case was lost to follow-up. The aetiology of the condition is unknown but we believe, on histological evidence, that it is congenital.

Adolescent↗
PubMed2004

'Pseudospongioplasty' in the repair of a urethral diverticulum.

OBJECTIVES: To describe a technique for repairing urethral diverticula which includes neourethral reconstruction and increasing the mechanical support of the neourethra. PATIENTS AND METHODS: Between February 1995 and May 2000, 267 patients with proximal hypospadias underwent a one-stage penile skin longitudinal flap urethroplasty. The overall postoperative complication rate was 20%; a diverticulum formed in 24 patients (9%) and in all it was repaired. Diverticulectomy was carried out by de-epithelialization of excess diverticular skin, so that two subcutaneous vascularized tissue wings could be created. After re-establishing distal urethral patency and neourethral closure, the de-epithelialized diverticular wings were folded and overlapped to form a mechanical support for the neourethral ventral wall; this procedure was termed 'pseudospongioplasty'. RESULTS: There were no recurrences of diverticulum or any fistula formation. The only complication was urethral stenosis in two cases, which was successfully resolved by internal urethrotomy. CONCLUSION: Re-establishing patency and providing mechanical support are essential when repairing a urethral diverticulum. Our technique with pseudospongiosal tissue reconstruction during the repair represents a good alternative or addition to other techniques.

Adolescent↗
PubMed2001

Meckel's diverticulum causing intestinal obstruction.

Meckel's diverticulum is an uncommon cause of acute abdominal pain and small bowel obstruction in adults. We present a case of a 31-yr-old man with recurrent vomiting and abdominal pain in whom the diagnosis of Meckel's diverticulum was not suspected until CT of the abdomen revealed multiple fluid-filled, dilated loops of ileum with distal collapse after normal abdominal radiographs. We suggest that CT may be helpful when the diagnosis of Meckel's diverticulum is suspected.

Adult↗
PubMed1998

Emphysematous cystitis and bladder trigone diverticulum in a dog.

A 14-month-old, male German shepherd dog was evaluated for chronic, recurrent Escherichia coli urinary tract infection. An initial diagnosis of emphysematous cystitis was made, which resolved with appropriate antibacterial therapy. The urinary tract infection, however, did not resolve and on further investigation a bladder trigone diverticulum was evident, thought to be congenital in origin. This report describes the apparent ultrasonographic and radiological changes, and surgical repair of the diverticulum, and reviews the literature with regard to both congenital bladder trigone diverticulum and emphysematous cystitis. The former has never been documented in the dog and the latter is an unusual finding in a non-diabetic dog.

Amoxicillin-Potassium Clavulanate Combination↗
PubMed1988

Congenital diverticulum of the right atrium situated on the floor of the coronary sinus.

A diverticulum of the right atrium was found on the floor of the coronary sinus in a neonate. The diverticulum was distinguished from a pericardial cyst by contrast echocardiography, and its relations with coronary sinus and coronary venous return were identified by coronary angiography. Because the diverticulum compressed the left ventricular inferior wall and prevented its growth, it was excised. Thebesian veins were discovered at operation and prevented complete correction of the defect.

Coronary Angiography↗
PubMed1998

Villous adenoma arising in Meckel's diverticulum.

The first well documented case of villous adenoma arising in a Meckel's diverticulum not associated with a carcinoma is reported. A 21 year old man with long history of medically treated ulcerative colitis was admitted to hospital with severe pain and bleeding. Total abdominal colectomy and ileo-anal anastomosis was performed and during this procedure Meckel's diverticulum containing a villous adenoma showing minimal dysplasia was found and resected. The diverticulum was lined partly by ileal and partly by gastric epithelium, and the villous adenoma originated from the gastric mucosa.

Adenoma, Villous↗
PubMed1992

Extended transduodenal sphincteroplasty for bile duct stones associated with a periampullary diverticulum.

Extended transduodenal sphincteroplasty has been suggested as an alternative to choledochoduodenostomy for the surgical management of bile duct stones associated with a periampullary diverticulum but its value has not previously been investigated. Over a 3 year period, nine patients underwent extended transduodenal sphincteroplasty for common bile duct calculi associated with a periampullary diverticulum with no operative or post-operative mortality and minimal morbidity. Follow-up ranging from 20 to 60 months has shown remission of pain in all but one patient, who has had a normal endoscopic cholangiogram and no further episodes of jaundice or cholangitis. Extended transduodenal sphincteroplasty is a safe and effective alternative to choledochoduodenostomy for the surgical management of choledocholithiasis associated with a periampullary diverticulum.

Aged↗
PubMed1981

Congenital saccular anterior urethral diverticulum.

Congenital saccular diverticulum is an uncommon abnormality of the anterior urethra in the male. In seven cases (6 infants and an 8-year-old boy) the diverticulum was well demonstrated by voiding cystourethrography and/or retrograde urethrography. In patients with saccular anterior urethral diverticulum, contrast material fills an oval outpouching of the ventral aspect of the anterior urethra. The clinical presentation, unique radiologic appearance, and differential diagnostic considerations are reviewed.

Child↗
PubMed2000

Intraluminal duodenal diverticulum causing acute pancreatitis: CT scan diagnosis and review of the literature.

BACKGROUND: Intraluminal duodenal diverticulum is a rare congenital anomaly. First described by Boyd in 1845, no more than 100 cases have been reported up to now: only 17 are associated with acute pancreatitis. METHODS: A new case of intraluminal duodenal diverticulum with acute pancreatitis is reported and the literature about this association reviewed. RESULTS: The diagnosis was made by helical CT scan. The pathogenesis of pancreatitis was possibly due to a pure duodenal content reflux through the papilla of Vater. The patient was successfully treated by surgery. CONCLUSIONS: Intraluminal duodenal diverticulum is a rare but curable cause of pancreatitis, usually affecting young people. We describe, for the first time, its unusual helical CT imaging with two-dimensional reformations.

Acute Disease↗
PubMedDate not supplied

Prenatal diagnosis of a congenital bladder diverticulum. Case report and benefits of prenatal diagnosis.

A case of congenital bladder diverticulum diagnosed at 37 weeks of gestation (measured from the first day after the last day of the last menstrual period) is reported. Delivery took place 24 h later. A postnatal urologic work-up confirmed the diagnosis of asymptomatic congenital bladder diverticulum. The infant underwent laparotomic surgery at the age of 6 months, with an extravesical diverticulectomy and ureteral reimplantation. There were no complications. This is the first case reported in the literature of a prenatal diagnosis of a congenital bladder diverticulum. This new aspect allows early management and avoidance of the diagnostic meanders to which the discovery of a pelvic mass might lead, as well as the complications that can follow bladder diverticula.

Adult↗
PubMed1999

Infected congenital urethral diverticulum in an adult male.

Congenital anterior urethral diverticulum is a rare anomaly. The majority present in infancy with urinary obstruction. Those who present beyond infancy do so on account of recurrent urinary tract infection or dribbling. We present a case of congenital anterior urethral diverticulum manifesting in adulthood with suppuration in the diverticulum.

Diverticulum↗
PubMedDate not supplied

Iron deficiency anaemia: an unusual complication of Meckel's diverticulum.

OBJECTIVES: To describe a case of Meckel's diverticulum with an unusual complication of iron deficiency anaemia due to chronic intestinal bleeding. CLINICAL PRESENTATION AND INTERVENTION: A 12-year-old boy presented with bloody diarrhoea and abdominal pain in association with a long-standing history of black stools and progressive pallor. Biochemical tests revealed low serum iron (1.2 mmol/l) indicating iron deficiency anaemia and low serum albumin (29 g/l). The other tests were normal. Colonoscopy performed on the 8th day of hospitalization was normal. A technetium-99m pertechnetate scan showed an ectopic gastric mucosa in the Meckel's diverticulum confirmed at surgery in the region of the antimesentric border and on histopathology. CONCLUSION: Findings indicated that the patient had a bleeding Meckel's diverticulum, complicated by iron deficiency anaemia.

Abdominal Pain↗
PubMed2001

Contrast harmonic power Doppler imaging of congenital ventricular diverticulum--a case report.

A case of an 81-year-old woman with a left ventricular diverticulum who underwent myocardial contrast echocardiography is reported. After administration of the contrast agent, a pulsed Doppler flow measurement clearly revealed the biphasic waveform of the ejection flow in the pre-systolic and systolic phase at the ostium of the diverticular cavity. A harmonic power Doppler image showed that part of the diverticulum wall had similar acoustic properties to the ventricular septal wall. Intracardiac blood flow and myocardial perfusion could be clearly evaluated and a ventricular diverticulum was correctly diagnosed using contrast echocardiography.

Aged↗
PubMed2005

Congenital giant diverticulum of the left ventricle in an adult.

Congenital diverticulum of the left ventricle is a rare anomaly. Echocardiography, cardiac catheterization, and magnetic resonance imaging of the heart diagnosed a giant left ventricular diverticulum in a 20-year-old male with a history of dyspnea and palpitations. He underwent successful surgical correction of the left ventricular diverticulum.

Adult↗
PubMedDate not supplied

Effects of a high jugular fossa and jugular bulb diverticulum on the inner ear. A clinical and radiologic investigation.

From a series of patients undergoing routine radiographic examination, 112 temporal bones with a high jugular fossa were selected. Among these, 43 jugular bulb diverticula were found. The structures affected by a high fossa or diverticulum were recorded and correlated to the clinical symptoms of the patient. The vestibule was suspected to be affected in five patients. Two of these patients had tinnitus and vertigo, and three had hearing loss. In one of the latter the hearing loss was most marked in the supine position. The cochlea was close to the fossa in three patients, all of whom had tinnitus. Four patients had a defect of the posterior semicircular canal. One of them lost his hearing after a severe fit of coughing, became unsteady and showed signs of a fistula. The internal acoustic meatus and the mastoid portion of the facial canal were affected in two and four patients, respectively, who had no recorded symptoms. Twelve of 34 patients with Menière's disease and a high jugular fossa on the side of the diseased ear had a dehiscence of the vestibular aqueduct caused by the fossa or diverticulum, compared with nine of 58 patients in the unselected material. For comparison and demonstration of topographic relationships, 58 casts of unselected radiographed temporal bone specimens with high jugular fossae or diverticula were investigated. In patients with a high jugular fossa or jugular bulb diverticulum, tomographic assessment may be of value.

Diverticulum↗