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PubMed1985

[Management of Meckel's diverticulum of fortuitous discovery].

A Meckel's diverticulum was discovered in 89 patients during routine exploration at the time of an appendicectomy. Subsequent treatment and complications of surgical correction of a Meckel's diverticulum are discussed. A different attitude appears necessary depending on whether the patient is a child or an adult : apart from some particular circumstances, a healthy diverticulum should be removed in children and left untouched in adults.

Adult↗
PubMed1977

[Carcinoma in Zenker's diverticulum (author's transl)].

Carcinoma arising in Zenker's diverticulum have to be thought of, if it has been present for long time, if there is blood mixed the food regurgitated, and if there are irregularities of the wall of the diverticulum to be detected radiologically. In most cases resection is the method of choice. A case of a 70 year old patient is reported, who harbored a microcarcinoma in the mucosa of a resected Zenker's diverticulum. Surgery was done 10 years ago and no recurrence or mestastases have been observed since.

Aged↗
PubMed1979

[Active search for Meckel's diverticulum].

Examination for Meckel's diverticulum is generally performed in each case of laparotomy where the incision allows observation of the small bowel without danger of spreading the infection. In 65 cases, pathologic alterations were found in 14 (= 21,5%). Postoperative bowel obstruction due to resection of Meckel's diverticulum has been found twice (3%), one patient died. It is suggested that Meckel's diverticulum be removed whenever possible.

Adolescent↗
PubMedDate not supplied

[Giant diverticulum of the sigmoid: A report on one case and review of the literature (author's transl)].

The authors report a case of giant diverticulum of the sigmoid and review the approximately forty cases published in the literature. Clinical manifestations can be either an acute abdominal syndrome of symptoms of a chronic disease. Radiological appearances are usually characteristic: the giant diverticulum is located in the sigmoid, though in one case it arose from the transverse colon. An opaque image was noted in 15 of the patients following barium meal examination, and the lesion was associated with diverticulosis of the colon in every case. Apart from 4 cases, histological appearances were also typical: the colon wall is composed of fibrous tissue which has replaced the normal layers, and the neck of the giant diverticulum is always in the antimesenteric position.

Aged↗
PubMed1983

Diverticulum of the common bile duct. A case report.

A rare choledochal diverticulum was found when a 56-year-old woman was operated on for obstructive icterus. The peroperative cholangiography finding was normal. However, palpation revealed a diverticulum of the intra-pancreatic portion of the common bile duct. Through transduodenal sphincterotomy stones and turbid bile were evacuated from the diverticulum. Excision from this anatomic region seemed to be impossible.

Cholecystectomy↗
PubMed1984

True uterine diverticulum. A partial müllerian duct duplication?

True uterine diverticulum is an exceedingly rare entity. We report only the second case, to our knowledge, of a nulliparous uterus containing a diverticulum communicating with the endometrial cavity. True uterine diverticula probably arise from a localized duplication of the distal Müllerian duct on one side. They may be confused pathologically with uterine sacculations of pregnancy, but tend to have thicker walls. Associated conditions include "ectopic" pregnancy in the diverticulum, dysmenorrhea, and abnormal uterine bleeding.

Adult↗
PubMed1984

[Congenital urethral diverticulum in a male infant: a case report].

A case of congenital anterior urethral diverticulum of a male infant is reported. The patient was a 3-year-old boy who had complained of a sac-like swelling and urinary fistula of the anterior penis. The diagnosis was made by means of retrograde urethrocystography. Diverticulectomy and cystostomy were done. The post-operative course was uneventful. The microscopic examination showed that the diverticulum was lined with normal urethral epithelium. We made a statistical survey on 47 male children up to 15 years of age with congenital anterior urethral diverticulum reported in the Japanese literature.

Child, Preschool↗
PubMed1983

A fifty year experience with Meckel's diverticulum.

Four hundred and two patients with Meckel's diverticulum are reviewed. Symptoms referable to the diverticulum occurred in 68 patients or 16.9 per cent of the group. Obstruction of the small intestine, inflammation and lower gastrointestinal tract bleeding accounted for 90 per cent of the presenting symptoms. A 10.3 per cent mortality and a 17.6 per cent morbidity rate were noted for symptomatic diverticuli. Patients most likely to have symptoms develop were 40 years of age, or younger; those whose diverticuli were 2 centimeters or more in length; those whose diverticuli contained heterotopic mucosa, and, probably, those who were males. Patients more than 40 years of age with diverticuli less than 2 centimeters in length with no heterotopic mucosa and who were females constitute a lower risk group. The decision to perform an incidental Meckel's diverticulectomy should be based upon the risk of the individual patient having symptoms develop from the diverticulum.

Adolescent↗
PubMed1983

Symptomatic inverted Meckel's diverticulum. Case report.

The radiographic diagnosis of Meckel's diverticulum in an asymptomatic individual is extremely difficult. Complications of the diverticulum may make preoperative diagnosis possible. A persistent, elongated filling defect within the distal ileum in a patient with chronic blood loss and symptoms of partial obstruction is most likely to be due to an inverted Meckel's diverticulum.

Barium Sulfate↗
PubMed1981

Recurrent acute pancreatitis and intussusception complicating an intraluminal duodenal diverticulum.

A patient is presented who exhibited recurrent episodes of acute pancreatitis as well as intermittent intussusception. It is felt that both of these abnormalities are due to an intraluminal duodenal diverticulum. The developmental theories of the intraluminal duodenal diverticulum are discussed. Early recognition of intraluminal duodenal diverticulum is aided by the awareness of its existence and the characteristic appearance on upper gastrointestinal barium examination. Surgery is curative.

Acute Disease↗
PubMed1982

[Meckel's diverticulum in the adult. Double-contrast study of 7 cases].

The authors report 7 cases of Meckel's diverticulum on a series of 500 double contrast small bowel enema (1,4%). In two cases, the diverticulum is not recognized by repletion study. So, they find that the double contrast small bowel enema is the most accurate method to detect a Meckel's diverticulum.

Adolescent↗
PubMed1982

Acute inflammation of pancreatic tissue in a Meckel's diverticulum.

The authors report what they believe is the first report in the English literature of acute inflammation of ectopic pancreatic tissue in a Meckel's diverticulum. A 29-year-old man presented with acute abdominal pain and a clinical diagnosis of acute appendicitis was made. Laparotomy revealed a normal appendix and a Meckel's diverticulum with gross inflammation at the distal end. Microscopic examination showed acute inflammation limited to ectopic pancreatic tissue in the wall of the diverticulum. Fat necrosis was present. The possible pathophysiologic mechanisms are discussed.

Adult↗
PubMed1982

[Giant diverticulum of the sigmoid colon. A rare complication of colonic diverticulosis. Review of the literature apropos of a case].

The authors report a case of giant diverticulum of the sigmoid colon, a very rare complication of diverticulosis of the colon, since only 38 cases have been reported in the literature. The diverticulum was seen at barium enema in a 66-year-old man complaining of digestive symptoms consisting of lower abdominal pain, tenesmus, diarrhea and fever. Segmental resection of the sigmoid colon including the site of implantation of the diverticulum with end-to-end anastomosis at the same operative stage led to definitive cure. On the basis of a study of the literature, the authors define the clinical, diagnostic and pathogenic characteristics of the condition.

Aged↗
PubMed1981

Meckel's diverticulum - an investigation based on pathological findings in 130 patients treated by surgery.

A retrospective investigation was carried out involving 130 patients from 5 hospitals in order to correlate symptoms with pathological findings in a surgically removed Meckel's diverticulum. In 20% of the patients surgery was performed because of complications due to the diverticulum, of which strangulation of the intestine and acute diverticulitis were the commonest. Heterotropic issue was found in 23% of the patients. The indication for prophylactic removal is dependent on the risk of complications; unanimity on this point does not exist in the literature and our own findings do not permit conclusions. However, they do confirm that the mortality rate for prophylactic removal of a diverticulum is virtually negligible.

Adolescent↗
PubMed1978

[Critical study of the value of superior mesenteric arteriography in the diagnosis of Meckel's diverticulum. Radiological and clinical findings in 10 cases (author's transl)].

The authors underline the value of selective superior mesenteric arteriography in the diagnosis of Meckel's diverticulum. In the ten cases reported, seven were found to have a Meckel's diverticulum on operation, while it was absent in the other three. Arteriography was able to diagnose its presence correctly in sex patients, gave a false positive diagnosis in three cases, and was considered to be normal in the last case in which a Meckel's diverticulum was present. Valid radiological signs are extravasation of the contrast medium into the lumen of the digestive tract and the presence of a vitellin artery dividing into a vascular network. The single fact of a hypervascularized zone at the end of the superior mesenteric artery dividing into a vascular network. The single fact of a hypervascularized zone at the end of the superior mesenteric artery without definite artery formation is not as valid and its interpretation is difficult.

Adolescent↗
PubMed1994

Meckel's diverticulum in exomphalos minor.

Fifty-four cases of exomphalos were reviewed. After the exclusion of five cases, seven out of 25 cases of exomphalos minor had co-existing Meckel's diverticulum compared with one out of 24 cases of exomphalos major. The high incidence of Meckel's diverticulum in exomphalos minor highlights the importance of surgical rather than manual reduction of the sac contents in order to exclude the presence of viscera from the sac before division. Also, the raised incidence of Meckel's diverticulum in general may well be due to a raised incidence in exomphalos minor in particular.

Child↗
PubMed1995

Endoscopic discision of Zenker's diverticulum.

Being typically an elderly make, the patient with a Zenker's diverticulum quite uncommonly presents in the best condition for surgery. Optimal management should therefore minimize the operative risk, shorten the time of postoperative hospitalization, and simultaneously avoid postoperative recurrence of the disorder. Using an automatic stapling device, the sphincter of the diverticulum (consisting mainly of the cricopharyngeus muscle) is cut easily endoscopically, with reliable haemostasis and a wide opening of the pouch as result. Six cases operated on by us between December 1993 and August 1994, became completely free of symptoms. The surgical technique (actually a variety of the traditional Dohlman's procedure) is described. Postoperative results over a follow-up of 3-8 months, and details of one non-serious postoperative complication are reported. Our experience of this pilot series gives rise to positive expectations of a new, safe, and time-saving procedure for successful treatment of even elderly patients with Zenker's diverticulum.

Aged↗
PubMed1994

[A case of association of cyst of the urachus and Meckel's diverticulum].

Meckel diverticulum and residual urachus have a common embryological origin: the yolk sac at the eight day of life. Their course is independent but the underlying mechanisms are identical. Meckel diverticulum occurs in 2 to 4% of the population. Clinical signs are often absent and complications occur in 4% of the cases (haemorrhage, occlusion, inflammation, and rarely tumoural formation). Residual urachus occurs as a cystic formation, a sinus or a fistulization and may degenerate into adenocarcinoma of severe prognosis. The reported association has not apparently been reported previously in the literature. Due to the risk of cancerization, it is suggested that residual urachus should be searched in cases of Meckel diverticulum.

Child, Preschool↗