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      Bleeding Meckel’s diverticulum in a 4-month-old infant: Treatment with laparoscopic diverticulectomy. A case report and review of the literature

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          Abstract

          A bleeding Meckel’s diverticulum is presented in a 4-month-old African American infant. This event is rare at this age, and our patient is only the second 4-month-old infant reported in the English literature. The infant presented with painless frank rectal bleeding, the blood being maroon-colored, and clots were found in the diaper. There was also anemia, with an hemoglobin of less than 8 gm/dl. The color of the blood suggested a bleeding site in the ileo-cecal region, a Meckel’s diverticulum was suspected, which was then confirmed by an isotope scan. A typical Meckel’s diverticulum was found on laparoscopic surgery, was excised, and the infant made an uneventful recovery.

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          Most cited references29

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          Complications and diagnosis of Meckel's diverticulum in 776 patients.

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            Vitelline duct anomalies. Experience with 217 childhood cases.

            Of 217 children with vitelline duct anomalies, 85 (40%) had symptomatic lesions (mean age, 2.4 years). Forty-eight patients presented with rectal bleeding; 28, with intestinal obstruction; five, with abdominal pain; and four, with bilious umbilical drainage. An asymptomatic Meckel's diverticulum was discovered incidentally at laparotomy in 132 children. Surgical therapy included bowel resection in nine patients with volvulus, four with intussusception, seven with bleeding, three with vitelline cysts, and one with a perforation. Diverticulectomy was performed in 189 cases, and excision of a patent vitelline duct was accomplished in four neonates with umbilical drainage. Ectopic gastric mucosa was present in all 48 patients with bleeding and in four of five with inflammation but in only two asymptomatic specimens. More than one third of the cases were symptomatic and presented in younger patients. This suggests that elective resection of asymptomatic vitelline remnants in early childhood is reasonable at the time of laparotomy for other conditions.
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              Meckel's diverticulum: a review of 148 pediatric patients, with special reference to the pattern of bleeding and to mesodiverticular vascular bands.

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                Author and article information

                Journal
                Clin Exp Gastroenterol
                Clinical and experimental gastroenterology
                Dove Medical Press
                1178-7023
                2009
                24 April 2009
                : 2
                : 37-40
                Affiliations
                [1 ]Clinical Professor of Pediatrics, Section of Pediatric Gastroenterology, Hepatology and Nutrition;
                [2 ]Resident in Pediatrics;
                [3 ]Assistant Professor of Surgery and Pediatrics, Section of Pediatric Surgery, Brody School of Medicine, East Carolina University, Greenville, NC, USA
                Author notes
                Correspondence: J Rainer Poley, Section of Pediatric Gastroenterology, Brody School of Medicine, 600 Moye Boulevard, Greenville NC 27834, USA, Tel +1 252 744 4963, Fax +1 252 744 2791, Email poleyr@ 123456ecu.edu
                Article
                ceg-2-037
                10.2147/ceg.s3792
                3108634
                21694825
                cd74b930-0c75-4af3-9466-c306d0a4afb7
                © 2009 Poley et al, publisher and licensee Dove Medical Press Ltd.

                This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.

                History
                Categories
                Case Report

                Gastroenterology & Hepatology
                infant-bleeding meckel’s diverticulum,laparoscopic diverticulectomy

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