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      Meckel's diverticulum: clinical features, diagnosis and management

      review-article
      Revista Española de Enfermedades Digestivas
      Sociedad Española de Patología Digestiva
      Meckel's diverticulum, Diagnosis, Complications, Management

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          Abstract

          ABSTRACT Meckel's diverticulum is the most common anomalous development of the gastrointestinal system that results from an incomplete vitelline canal. A diagnosis is usually made during the clinical examination of presentations such as unexplained gastrointestinal bleeding, obstruction, inflammation or perforation. The purpose of this review is to provide an adequate level of knowledge of the clinical and diagnostic features as well as the management of Meckel's diverticulum. Diagnosis of Meckel's diverticulum may be challenging as the condition remains asymptomatic or may mimic various diseases and obscure the clinical picture. Life-threatening complications include bleeding, obstruction, inflammation and perforation. Therefore, it is essential that anatomical and pathophysiological characteristics are known in detail in order to prevent complications which will result in morbidity and mortality.

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          Most cited references41

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          Complications of Meckel's diverticula in adults.

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            Imaging manifestations of Meckel's diverticulum.

            Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract, found in 2% of the population in autopsy studies. Most patients remain asymptomatic during their lifetime. Complications of Meckel's diverticulum are reported to occur in approximately 4-40% of patients and include inflammation (diverticulitis), hemorrhage, intussusception, small-bowel obstruction, stone formation, and neoplasm. The purpose of this article is to familiarize the radiologist with the current imaging of Meckel's diverticulum and its presenting complications. The spectrum of diagnostic findings on various imaging techniques will be reviewed. Meckel's diverticulum and its complications are a serious health problem. Familiarity of the radiologist with the appearance of this pathologic entity enables an accurate diagnosis in emergent settings.
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              Meckel's diverticulum in children: a 20-year review.

              Meckel's diverticulum occurs in 2% of the population and may present at any age. Its management, when found incidentally at laparotomy, remains controversial, particularly in the pediatric population. From 1970 to 1989, a Meckel's diverticulum was discovered in 164 children at laparotomy. There were 120 boys and 44 girls with a mean age of 5.2 years (range, 0 to 18 years). Forty-seven cases were asymptomatic, representing an incidental finding at laparotomy, 25 were resected, and ectopic gastric mucosa was present in 7 specimens (28%). Three postoperative deaths (6%) that were not related to the resection and 2 complications (4%) (postoperative leak and wound infection) occurred in this group. Of the 117 symptomatic patients, 49 (42%) presented with bowel obstruction, 45 (38%) had rectal bleeding, 16 (14%) had diverticulitis, and 7 (6%) had umbilical pathology. Volvulus (20) and intussusception (19) were the most common causes of obstruction. Predisposing factors for bowel obstruction were fibrous bands to umbilicus or mesentery (37%) and ectopic mucosa (35%). Severe painless rectal bleeding occurred in 45 patients, 30 of whom (67%) required blood transfusion. A nuclear medicine Meckel scan was positive in 32 of 37 patients (85%). Contrast studies were not diagnostic; colonoscopy and gastroscopy ruled out other causes of bleeding. Patients with diverticulitis (16) presented with acute abdominal pain compatible with appendicitis. In the symptomatic group, ectopic mucosa was present in 61% of the resected specimens. Gastric (88%), pancreatic (7%), and gastric with pancreatic (3%) were the most common ectopic tissue. Postoperative morbidity and mortality for symptomatic patients was 8.5% and 0%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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                Author and article information

                Contributors
                Role: ND
                Journal
                diges
                Revista Española de Enfermedades Digestivas
                Rev. esp. enferm. dig.
                Sociedad Española de Patología Digestiva (Madrid, Madrid, Spain )
                1130-0108
                November 2018
                : 110
                : 11
                : 726-732
                Affiliations
                [1] Ankara orgnameAnkara Education and Research Hospital orgdiv1Department of General Surgery Turkey
                Article
                S1130-01082018001100008
                10.17235/reed.2018.5628/2018
                30032625
                7bddb953-8737-479e-a465-1e5734ae6427

                http://creativecommons.org/licenses/by/4.0/

                History
                : 04 April 2018
                : 03 June 2018
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 48, Pages: 7
                Product

                SciELO Spain

                Categories
                Review

                Management,Complications,Diagnosis,Meckel's diverticulum

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