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We report on a 50-year-old male patient with acquired urethral diverticulum complicated by calculus in the anterior urethra. The etiologic factors, the hypotheses put forward relative to the pathogenesis of urethral diverticulum, its diagnosis and forms of treatment are discussed.
A clinical case of angiodysplasia of the colon, Meckel's diverticulum and mitral valve prolapse is reported in a 20 year old man. Association of vascular ectasia of the colon and Meckel's diverticulum has been reported in a few cases but rarely with other kinds of malformation. This brief clinical paper reports a congenital aetiology of an uncommon disease of the colon, such as angiodysplasia in a young male.
An observation is presented, of a female patient aged 62 years with a large abdominal tumour. Clinical and para-clinical examinations could not establish the organic origin of the formation. Surgery disclosed a giant tumour developed in a gastric diverticulum situated under the cardia. The patient had suffered for a long time with gastric symptoms and her antecedents included upper digestive haemorrhage which was attributed to gastric ulcer according to radiological examination. In retrospect it was established that the disturbances were determined by a gastric diverticulum, complicated by haemorrhage and which later on had become malignant. In spite of its extraordinarily large size the tumour was removed by total gastric resection, in an attempt to treat radically the cancer.
Meckel's diverticulum, a relatively common congenital anomaly of the gastrointestinal tract, is present in approximately 2 percent of the population. When symptoms develop, they are usually the result of inflammation, hemorrhage or obstruction. Diagnosis is made by maintaining a high index of suspicion, carefully reviewing data from the history and physical examination, and performing a radionuclide scan. Surgical removal is usually indicated when symptoms occur. An asymptomatic Meckel's diverticulum that is discovered incidentally at surgery should usually be removed unless contraindications exist.
Meckel's diverticulum with ulcer was reported. A 76-year-old man visited our hospital with melena. X-ray examination of the small intestine by double contrast method demonstrated a diverticulum with ulcer of the ileum. This case was followed up by X-ray examination.
We report the case of a 38-year-old woman who underwent cardiac catheterization because of cyanosis from birth. This study revealed a right ventricular cavity hypoplasia, an atrial septal defect, and a diverticulum originated from the free right ventricular wall. Ventricular diverticuli, especially those in the right ventricle, are very rare malformations, usually associated with other cardiac defects. The right ventricular diverticulum is generally non-symptomatic, diagnosed by chance, and does not usually require surgical treatment.
A case is described of a giant acquired diverticulum of the anterior portion of the urethra. The cause was stricture of the penile part of the urethra. With time a large number of calculi developed in the diverticulum. The method of surgical treatment and the postoperative course are described calling attention to the importance of postoperative management of such cases.
The Zenker posterior pharyngoesophageal diverticulum results from the posterior herniation of the hypopharyngeal intima near its junction with esophagus. To its occurrence contribute more factors exerted at the level of Leimer's triangle. It has a slow progressive evolution and may thus vary in size from a beam to an apple or even the head of a foetus, determining compressions against the esophagus. The clinical symptoms depend on the evolutive stage. The radiological semiology of the evolutive stages of Zenker diverticulum is discussed and a casuistics with its various radiological aspects is presented.
A 5-year-old boy is described with bleeding from Meckel's diverticulum diagnosed preoperatively by technetium scintigraphy. Despite limited indications to radioisotope methods in children they are valuable diagnostic procedures in preoperative diagnosis of the presence of ectopic tissue in Meckel's diverticulum.
The accidental finding of a carcinoid tumour in Meckel's diverticulum, a very uncommon event, triggered a physiopathological and clinical analysis of this very interesting but very rare association. The value of systematic identification and removal of the diverticulum during laparotomy is underlined.
Meckel's diverticulum is a rare pathological condition with an incidence about 2%. We are presenting here a rare case report of a perforation of the terminal ileum caused by enterolithiasis of a Meckel's diverticulum. This patient has had repeated sub-occlusive states which was improved under conservative medical treatment. The operative decision was justified on bases of the evidence of an abdominal lesion discovered on barium follow-through and abdominal CT-scan.
During the last 27 years, 84 patients with Meckel's diverticulum (MD) have undergone resection at our institution (incidental findings, n = 50; MD with complications, n = 34). The most frequent complications of MD were obstruction and diverticulitis. Analysis of records of patients revealed that MD is a rare intraoperative finding. The calculated incidence was 2.4 per cent, and the ratio of diverticulectomy to appendectomy was 1:55. A preoperative diagnosis of MD was rare (4 per cent). Only in those patients with hemorrhage were diagnostic procedures (angiography, scintigraphy and roentgenography) useful. Ectopic tissues occurred in 23 per cent of all patients and were observed more often in patients with complications of MD. There was a correlation between hemorrhage and gastric heterotopic tissue. Another correlation was found between invagination and pancreatic tissue as well as diverticulitis. Postoperative adhesions causing ileus was the main complication found after resection for MD (8 per cent), whereas no other severe complications were observed (no insufficiency). There was no death as a result of resection. Because of the low rate of postoperative complications and the latent risk of complications arising sometime during life in sporadic episodes, a prophylactic resection is indicated but is often performed too late because the primary endangered group for complications is children who are less than two years of age. Predominantly in those with hemorrhage, the base of the diverticulum should be carefully checked for heterotopic tissue to prevent further complications.
A case of subcardial gastric diverticulum was surgically treated by an original technique which provided good exposure of the lesion and made it possible to sever all adhesions between the diverticulum and adjacent organs. This technique avoids gastrotomy and partial gastric resection.
Altogether 84 children aged 1 to 15 were examined. The index of 99mTc-pertechnetate relative accumulation in the ectopic gastric mucosa was proposed to be used to objectify and improve the quality of diagnosis of Meckel's diverticulum. The index over 42% was shown to be typical of Meckel's diverticulum and it can be used for automated diagnosis of the disease. The use of the above quantitative index made it possible to reject 20% of false positive results obtained at visual interpretation of scintigrams.
A case report of bleeding from a Meckel's diverticulum diagnosed by Tc99-m pertechnetate scanning is presented. The noninvasive advantage of this method justifies its early use as a diagnostic measure when a Meckel's diverticulum is suspected in the differential diagnosis of lower gastrointestinal bleeding.
The literature data concerning the incidence of Meckel's diverticulum in the adult and the frequency of its complications are examined and problems associated with the preoperative diagnosis of this form are discussed. Reference is made to the limitations of abdominal scintiscanning and the encouraging results obtained with superior mesenteric arteriography in diverticular bleeding. Five cases of Meckel's diverticulum in the adult are presented. Stress is placed on the need to explore the ileum during appendicectomy to enable diverticula to be detected and removed, since they are often the cause or the site of complications, even in the adult.
Neoplasms arising in Meckel's diverticulum or involving hernia sacs are rare. The authors present a unique case of two asymptomatic carcinoid tumors arising in a Meckel's diverticulum, which were discovered because of microscopic metastasis in a grossly unremarkable inguinal hernia sac. This article describes the clinical and morphologic features of this unusual case, reviews the topic of neoplasms involving hernia sacs and Meckel's diverticula, and includes a brief review of immunocytochemical findings in carcinoid tumors.
A complication of colonic diverticulosis, giant diverticula are seen above all in the sigmoid region. On the basis of a case involving the transverse colon, the authors stress the clinical and ultrasonographic pseudo-tumoural symptomatology as well as the degree of superinfection of the contents. Anatomical arguments would be in favour of pathogenesis by progressive increase in size of an ordinary diverticulum rather than by perforation with secondary encystment. Excision of the diverticulum required segmental colectomy.