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1
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De Dyn S, Demirci I, Prescher A, Kopp A, Klosterhalfen B, Janßen H. Mechanical ileus of the small bowel due to an inflamed Meckel's diverticulum with an enterolith - a case report with literature review. Acta Chir Belg 2023; 123:699-706. [PMID: 36259265 DOI: 10.1080/00015458.2022.2136047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 10/09/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Meckel's diverticula result from incomplete obliteration and regression of the omphaloenteric duct and are the most common congenital intestinal malformations. Many Meckel's diverticula remain asymptomatic and are discovered as incidental findings. They present a diagnostic challenge. METHODS We report the case of a 35-year-old man who presented with an acute abdomen and ileus. Computed tomography of the abdomen showed a mechanical small bowel ileus. There was a calibre jump in the terminal ileum with a round endoluminal definable hyperdense structure of almost 2 cm in diameter. RESULTS An exploratory laparoscopy was performed revealing an inflamed Meckel's diverticulum with impacted enterolith as the cause of the intestinal obstruction. CONCLUSION In symptomatic Meckel's diverticula, haemorrhage and obstruction are the most common complications. The development of ileus due to a Meckel's diverticulum with an enterolith is considered extremely rare but should be taken into account.
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Affiliation(s)
- Stephan De Dyn
- Department of General, Abdominal, Vascular and Thoracic Surgery, Krankenhaus Düren, Düren, Germany
| | - Ilhan Demirci
- Department of Vascular Surgery, Marienhospital Aachen, Aachen, Germany
| | - Andreas Prescher
- Institute of Molecular and Cellular Anatomy, RWTH Aachen, Aachen, Germany
| | - Andreas Kopp
- Department of Diagnostic and Interventional Radiology, Krankenhaus Düren, Düren, Germany
| | | | - Hermann Janßen
- Department of General, Abdominal, Vascular and Thoracic Surgery, Krankenhaus Düren, Düren, Germany
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2
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de Silva GPUP, Rathnasena BGN, Karunadasa MSE. An unusual case of small intestinal obstruction secondary to a large primary enterolith. SAGE Open Med Case Rep 2023; 11:2050313X231185952. [PMID: 37465063 PMCID: PMC10350780 DOI: 10.1177/2050313x231185952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 06/16/2023] [Indexed: 07/20/2023] Open
Abstract
Enterolithiasis is an uncommon entity in humans but frequently seen in equine mammals. A primary enterolith is a mineral concretion formed within the gastrointestinal tract due to the alteration in the anatomical integrity due to variety of conditions resulting in intestinal stasis. We report a patient with small intestinal obstruction due to a primary enterolith. A 65-year-old woman presented to the emergency department with central colicky abdominal pain, absolute constipation followed by vomiting. An enterolith located in distal ileum causing small intestinal obstruction was established with the aid of abdominal X-ray radiograph and computed tomography. Exploratory laparotomy was performed to extract the enterolith and to resect a strictured proximal jejunal segment which was suspected to be the original site of enterolith formation. Chemical analysis of the enterolith supports the speculation of a proximally formed primary enterolith eventually migrating to the site of impaction in the terminal ileum.
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Affiliation(s)
- G P U P de Silva
- Postgraduate Institute of Medicine, University of Colombo, Colombo, Sri Lanka
| | - B G N Rathnasena
- Department of Surgery, National Hospital of Sri Lanka, Colombo, Sri Lanka
| | - M S E Karunadasa
- Department of Surgery, Faculty of Medicine, Wayamba University of Sri Lanka, Kuliyapitiya, Sri Lanka
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3
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Callan R, Assaf N, Shaikh MI, Chattopadhyay D. Rare case of a patient with symptomatic Meckel's diverticulum enteroliths. BMJ Case Rep 2021; 14:14/2/e240815. [PMID: 33608344 PMCID: PMC7896579 DOI: 10.1136/bcr-2020-240815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A 61-year-old man presented with non-specific abdominal symptoms, including left groin pain and change in bowel habits. Investigations revealed a cystic lesion, containing numerous irregular calcifications, with the primary differential being a dermoid cyst containing teeth-like calcifications. At laparoscopy it was found to be a Meckel's diverticulum, containing a large number of enteroliths. This case revealed the importance of considering enteroliths in patients with imaging showing intra-abdominal calcifications, and laparoscopy for diagnosis and treatment.
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Affiliation(s)
- Rory Callan
- General Surgery, Bedfordshire Hospitals NHS Foundation Trust, Bedford, UK
| | - Nazrin Assaf
- General Surgery, Bedfordshire Hospitals NHS Foundation Trust, Bedford, UK
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4
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Shimagaki T, Konishi K, Kawata K, Edahiro K, Edagawa M, Takenaka T, Ohmine T, Kinjo N, Yamaguchi S, Maeda T, Tsutsui S, Matsuda H. A case of perforation of Meckel's diverticulum with enterolith. Surg Case Rep 2020; 6:161. [PMID: 32632651 PMCID: PMC7338335 DOI: 10.1186/s40792-020-00926-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 06/26/2020] [Indexed: 12/24/2022] Open
Abstract
Background Perforation of Meckel’s diverticulum with enteroliths is a rare complication. Here, we report a case of perforation of Meckel’s diverticulum with one enterolith, which could not be accurately diagnosed by preoperative computed tomography. Case presentation A 16-year-old male patient with acute onset of severe abdominal pain and a localized muscle guarding in the right hypochondrium had a solitary stone detected in the right abdomen by radiography. Abdominal computed tomography revealed a saclike outpouching of the small intestine, which contained fluid levels and an enterolith, with a mesenteric inflammatory change in the right paraumbilical area. He was diagnosed with peritonitis due to appendicitis or Meckel’s diverticulitis with enterolith, and emergency operation was indicated. The perforated Meckel’s diverticulum was identified approximately 30 cm proximal to the ileocecal valve. The diverticulum was transected at the base and removed. The patient’s postoperative course was uneventful. Conclusions It is crucial for clinicians to thoroughly examine patients and appropriately request investigations that consider perforation of Meckel’s diverticulum as a possible diagnosis to facilitate prompt treatment.
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Affiliation(s)
- Tomonari Shimagaki
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima, 730-8619, Japan.
| | - Kozo Konishi
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima, 730-8619, Japan
| | - Koto Kawata
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima, 730-8619, Japan
| | - Keitaro Edahiro
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima, 730-8619, Japan
| | - Makoto Edagawa
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima, 730-8619, Japan
| | - Tomoyoshi Takenaka
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima, 730-8619, Japan
| | - Takahiro Ohmine
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima, 730-8619, Japan
| | - Nao Kinjo
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima, 730-8619, Japan
| | - Shohei Yamaguchi
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima, 730-8619, Japan
| | - Takashi Maeda
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima, 730-8619, Japan
| | - Shinichi Tsutsui
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima, 730-8619, Japan
| | - Hiroyuki Matsuda
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima, 730-8619, Japan
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5
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Choe J, Wortman JR, Michaels A, Sarma A, Fulwadhva UP, Sodickson AD. Beyond appendicitis: ultrasound findings of acute bowel pathology. Emerg Radiol 2019; 26:307-317. [PMID: 30661212 DOI: 10.1007/s10140-019-01670-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Accepted: 01/03/2019] [Indexed: 12/14/2022]
Abstract
Bowel pathology is a common unexpected finding on routine abdominal and pelvic ultrasound. However, radiologists are often unfamiliar with the ultrasound appearance of the gastrointestinal tract due to the underutilization of ultrasound for bowel evaluation in the USA. The purpose of this article is to familiarize radiologists with the characteristic ultrasound features of a variety of bowel pathologies. Basic ultrasound technique for bowel evaluation, ultrasound appearance of normal bowel, and key ultrasound features of common acute bowel abnormalities will be reviewed.
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Affiliation(s)
- Jihee Choe
- Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
| | - Jeremy R Wortman
- Department of Radiology, Lahey Hospital and Medical Center, Burlington, MA, USA
| | - Aya Michaels
- Department Radiology, Weill Cornell Medicine, New York, NY, USA
| | - Asha Sarma
- Department of Radiology and Radiological Sciences, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Urvi P Fulwadhva
- Department of Radiology, Lahey Hospital and Medical Center, Burlington, MA, USA
| | - Aaron D Sodickson
- Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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6
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Noukpozounkou SB, Lawani I, Elegbede OTA, Seto DM, Assan BR, Houegban ASCR, Koco H, Fiogbe MA. [Littré's strangled umbilical hernia in children: a rare complication due to a common malformation of the small bowel]. Pan Afr Med J 2018; 30:214. [PMID: 30574233 PMCID: PMC6294977 DOI: 10.11604/pamj.2018.30.214.14486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 01/06/2018] [Indexed: 11/13/2022] Open
Abstract
Le diverticule de Meckel est l'anomalie congénitale la plus fréquente de l'intestin grêle. Bien qu'il s'agisse d'une anomalie courante dans la population générale, sa présence dans un sac herniaire, en particulier au niveau ombilical est une situation peu fréquente et constitue la hernie de Littré. Nous rapportons le cas d'un nourrisson de 6 mois de sexe féminin, admis pour une tuméfaction ombilicale douloureuse et irréductible. Le diagnostic de hernie ombilicale étranglée a été posé. En per opératoire, il était découvert dans le sac herniaire un diverticule de Meckel inflammatoire. On procéda à une résection cunéiforme du diverticule suivie de la fermeture de la brèche intestinale par une suture en surjet et de la réfection pariétale. Le diagnostic clinique de la hernie de Littré est difficile et l'attitude thérapeutique varie selon les équipes.
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Affiliation(s)
| | - Ismaïl Lawani
- Département de Chirurgie, Faculté des Sciences de la Santé, Université d'Abomey-Calavi, Cotonou, Bénin
| | | | - Djifid Morel Seto
- Clinique Universitaire de Chirurgie Pédiatrique CNHU-HKM, Cotonou, Bénin
| | | | | | - Houenoukpo Koco
- Clinique Universitaire de Chirurgie Pédiatrique CNHU-HKM, Cotonou, Bénin
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7
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Mani VR, Kalabin A, Dinesh A, Rajabalan A, Landa M, Adu A. Inverted Meckel's Diverticulum: Rare Etiology of an Intestinal Obstruction. Cureus 2017; 9:e1806. [PMID: 29308334 PMCID: PMC5749936 DOI: 10.7759/cureus.1806] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Acute gastrointestinal obstruction can have a varied spectrum of clinical presentation and etiologies. It has been studied in detail and the management criteria have been well defined for the most part in our era. The etiologies are usually well defined. However, acute small bowel obstruction (SBO) due to intussusception caused by an inverted Meckel's diverticulum is a rare phenomenon that is often times missed on initial presentation and/or consequently until resected and visualized on pathological examination. We present a case of a 34-year-old presenting with symptoms and signs of acute intestinal obstruction and radiographic exam showing ileo-ileal intussusception. The patient failed to improve initially following conservative management and was taken to the operating room for small bowel resection which then revealed an inverted Meckel’s diverticulum.
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Affiliation(s)
- Vishnu R Mani
- Department of Surgery, New York University School of Medicine, and the Laura and Isaac Perlmutter Cancer Center, Columbia University School of Physicians and Surgeons at Harlem Hospital Center
| | - Aleksandr Kalabin
- Department of General Surgery, Columbia University College of Physicians and Surgeons at Harlem Hospital Center
| | - Anant Dinesh
- Department of General Surgery, Columbia University College of Physicians and Surgeons at Harlem Hospital Center
| | | | - Marina Landa
- Pathology, Columbia University College of Physicians and Surgeons at Harlem Hospital Center
| | - Albert Adu
- Department of General Surgery, Columbia University College of Physicians and Surgeons at Harlem Hospital Center
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8
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Reminiscing on Remnants: Imaging of Meckel Diverticulum and Its Complications in Adults. AJR Am J Roentgenol 2017; 209:W287-W296. [PMID: 28834452 DOI: 10.2214/ajr.17.18088] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Meckel diverticulum may become symptomatic if it is complicated by hemorrhage, intestinal obstruction, diverticulitis, or tumor. Although classically described in children, it is often missed in adults because of lack of suspicion and difficulty in detection. The purpose of this article is to review the imaging findings and management of Meckel diverticulum and its complications. CONCLUSION Although it is infrequently encountered incidentally, Meckel diverticulum should be considered especially when interpreting examinations for abdominal pain, small-bowel obstruction, and gastrointestinal bleeding.
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9
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Dill T, Sugo E, McManus B. Enteroliths and multiple neuroendocrine tumours in a Meckel's diverticulum. Pathology 2017; 49:319-322. [PMID: 28267995 DOI: 10.1016/j.pathol.2016.10.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Accepted: 10/26/2016] [Indexed: 10/20/2022]
Affiliation(s)
- Tony Dill
- Pathology North, John Hunter Hospital, Newcastle, NSW, Australia.
| | - Ella Sugo
- Pathology North, John Hunter Hospital, Newcastle, NSW, Australia
| | - Brendan McManus
- Newcastle Endoscopy Centre and John Hunter Hospital, Newcastle, NSW, Australia
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10
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11
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Maurice AP, Dickfos M, Mousa P, Bhardwaj H, Godinho S, Iswariah H, Chandrasegaram M. Meckel's diverticulum enteroliths causing small bowel obstruction. ANZ J Surg 2016; 88:E475-E476. [PMID: 26762683 DOI: 10.1111/ans.13423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Andrew Phillip Maurice
- Department of General Surgery, The Prince Charles Hospital, Brisbane, Queensland, Australia.,Northside Clinical School, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Marilla Dickfos
- Department of General Surgery, The Prince Charles Hospital, Brisbane, Queensland, Australia.,Northside Clinical School, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Paul Mousa
- Department of General Surgery, The Prince Charles Hospital, Brisbane, Queensland, Australia.,Northside Clinical School, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Hemant Bhardwaj
- Northside Clinical School, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.,Department of Radiology, The Prince Charles Hospital, Brisbane, Queensland, Australia
| | - Savio Godinho
- Northside Clinical School, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.,Department of Radiology, The Prince Charles Hospital, Brisbane, Queensland, Australia
| | - Harish Iswariah
- Department of General Surgery, The Prince Charles Hospital, Brisbane, Queensland, Australia.,Northside Clinical School, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Manju Chandrasegaram
- Department of General Surgery, The Prince Charles Hospital, Brisbane, Queensland, Australia.,Northside Clinical School, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
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12
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Yenidoğan E, Kayaoğlu HA, Okan İ, Özsoy Z, Tali S, Şahin M. Acute abdomen due to Meckel's enterolith: Case report and review of the literature. ULUSAL CERRAHI DERGISI 2015; 31:174-6. [PMID: 26504424 DOI: 10.5152/ucd.2015.2781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Accepted: 06/22/2014] [Indexed: 11/22/2022]
Abstract
Meckel's diverticulum is a rare condition with an incidence of 1-3% in general population. It is usually asymptomatic and is incidentally detected during laparotomy/laparoscopy. Enterolith formation within Meckel's diverticulum is even rarer. Herein, we present the diagnosis and management of a 50-year old patient with Meckel's diverticulum enterolith and discuss this rare condition based on the literature.
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Affiliation(s)
- Erdinç Yenidoğan
- Department of General Surgery, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey
| | - Hüseyin Ayhan Kayaoğlu
- Department of General Surgery, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey
| | - İsmail Okan
- Department of General Surgery, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey
| | - Zeki Özsoy
- Department of General Surgery, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey
| | - Servet Tali
- Department of General Surgery, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey
| | - Mustafa Şahin
- Department of General Surgery, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey
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13
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Abstract
Enterolithiasis or formation of gastrointestinal concretions is an uncommon medical condition that develops in the setting of intestinal stasis in the presence of the intestinal diverticula, surgical enteroanastomoses, blind pouches, afferent loops, incarcerated hernias, small intestinal tumors, intestinal kinking from intra-abdominal adhesions, and stenosing or stricturing Crohn’s disease and intestinal tuberculosis. Enterolithiasis is classified into primary and secondary types. Its prevalence ranges from 0.3% to 10% in selected populations. Proximal primary enteroliths are composed of choleic acid salts and distal enteroliths are calcified. Clinical presentation includes abdominal pains, distention, nausea, and vomiting of occasionally sudden but often fluctuating subacute nature which occurs as a result of the enterolith tumbling through the bowel lumen. Thorough history and physical exam coupled with radiologic imaging helps establish a diagnosis in a patient at risk. Complications include bowel obstruction, direct pressure injury to the intestinal mucosa, intestinal gangrene, intussusceptions, afferent loop syndrome, diverticulitis, iron deficiency anemia, gastrointestinal hemorrhage, and perforation. Mortality of primary enterolithiasis may reach 3% and secondary enterolithiasis 8%. Risk factors include poorly conditioned patients with significant obstruction and delay in diagnosis. Treatment relies on timely recognition of the disease and endoscopic or surgical intervention. With advents in new technology, improved outcome is expected for patients with enterolithiasis.
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14
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Kotha VK, Khandelwal A, Saboo SS, Shanbhogue AKP, Virmani V, Marginean EC, Menias CO. Radiologist's perspective for the Meckel's diverticulum and its complications. Br J Radiol 2014; 87:20130743. [PMID: 24611767 PMCID: PMC4075535 DOI: 10.1259/bjr.20130743] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The Meckel's diverticulum is the commonest congenital anomaly of the gastrointestinal tract, often presenting with complications such as gastrointestinal bleeding, intussusception, bowel obstruction and diverticulitis, which are often misdiagnosed. Imaging plays an important role in the early diagnosis and characterization of these conditions and is very helpful in decision making. The Meckel's diverticulum and its complications have myriad presentations and appearances on various imaging modalities. Thus, sound knowledge of the anatomy, embryology, clinical presentation, imaging characteristics and complications is crucial to the practice of abdominal imaging. We present a review of the literature and current radiological practices in the diagnosis and management of the Meckel's diverticulum and its various complications with special emphasis on the imaging of various complications, mimickers and pathological correlation.
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Affiliation(s)
- V K Kotha
- Department of Medical Imaging, St Michael's Hospital, University of Toronto, Toronto, ON, Canada
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15
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Perforated Meckel's Diverticulum Lithiasis: An Unusual Cause of Peritonitis. Case Rep Surg 2013; 2013:825628. [PMID: 23819094 PMCID: PMC3681262 DOI: 10.1155/2013/825628] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2013] [Accepted: 05/19/2013] [Indexed: 11/25/2022] Open
Abstract
Meckel's diverticulum is the commonest congenital malformation of gastrointestinal tract and represents a persistent remnant of the omphalomesenteric duct. Although it mostly remains silent, it can present as bleeding, perforation, intestinal obstruction, intussusception, and tumours. These complications, especially bleeding, tend to be more common in the paediatric group and intestinal obstruction in adults. Stone formation (lithiasis) in Meckel's diverticulum is rare. We report a case of Meckel's diverticulum lithiasis which presented as an acute abdomen in an otherwise healthy individual. The patient underwent an exploratory laparotomy which revealed a perforated Meckel's diverticulum with lithiasis; a segmental resection with end-to-end anastomosis of small bowel was performed. Patient recovery was delayed due to pneumonia, discharged on day 20 with no further complications at 6 months following surgery.
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16
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Demetriou V, McKean D, Briggs J, Moore N. Small bowel obstruction secondary to a liberated Meckel's enterolith. BMJ Case Rep 2013; 2013:bcr-2013-008868. [PMID: 23729702 DOI: 10.1136/bcr-2013-008868] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 30-year-old woman presented with a short history of abdominal pain which rapidly progressed to absolute constipation. An abdominal radiograph demonstrated a paucity of bowel gas and a 4 cm lesion with concentric laminar calcification projected over the pelvis. A CT scan revealed a 4 cm giant Meckel's diverticulum, downstream of which a laminated mass was impacted in the lumen of the distal ileum causing small bowel obstruction. Subsequent surgery confirmed small bowel obstruction secondary to impaction of a liberated enterolith from the giant Meckel's diverticulum. The history, imaging appearances and surgical findings in this case are classical of this unusual but treatable condition.
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17
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Tewari A, Weiden J, Johnson JO. Small-bowel obstruction associated with Crohn's enterolith. Emerg Radiol 2013; 20:341-4. [PMID: 23392960 DOI: 10.1007/s10140-013-1107-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Accepted: 01/29/2013] [Indexed: 12/11/2022]
Abstract
One of the lesser known clinical manifestations of Crohn's disease is the formation of small-bowel enteroliths. These concretions precipitate in the setting of small-bowel stasis within the alimentary tract and are associated with a variety of disease states causing strictures or diverticula. In the acute setting, patients typically present with signs of intestinal obstruction due to stone impaction. The case we report involves a 67-year-old female with long-standing Crohn's disease who presented with a 6-day history of worsening abdominal pain. Plain abdominal radiographs demonstrated dilated bowel loops consistent with intestinal obstruction. Computed tomography revealed a 2.5-cm calcified density at the transition point in the distal ileum, and two additional stones were present in the proximal ileum. At surgery, multiple ileal strictures were found, and ileocolic resection with primary anastomoses was performed. The accurate diagnosis of enterolithiasis in the setting of Crohn's disease has significant clinical implications for management and is a harbinger of underlying bowel stenosis.
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Affiliation(s)
- Anuj Tewari
- Division of Emergency Radiology, Emory University School of Medicine, Atlanta, GA, USA.
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18
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Rashid OM, Ku JK, Nagahashi M, Yamada A, Takabe K. Inverted Meckel's diverticulum as a cause of occult lower gastrointestinal hemorrhage. World J Gastroenterol 2012; 18:6155-9. [PMID: 23155346 PMCID: PMC3496894 DOI: 10.3748/wjg.v18.i42.6155] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2012] [Revised: 07/09/2012] [Accepted: 07/18/2012] [Indexed: 02/06/2023] Open
Abstract
Meckel’s diverticulum is a common asymptomatic congenital gastrointestinal anomaly, but rarely it can present with hemorrhage. Over the last few years inverted Meckel’s diverticulum has been reported in the literature with increasing frequency as an occult source of lower gastrointestinal hemorrhage. Here, we report a case of a 54-year-old male, who was referred for surgical evaluation with persistent anemia and occult blood per rectum after a work up which failed to localize the source over 12 mo, including upper and capsule endoscopy, colonoscopy, enteroclysis, Meckel scan, and tagged nuclear red blood cell scan. An abdominal computed tomography scan showed a possible mid-ileal intussusception and intraluminal mass. During the abdominal exploration, inverted Meckel’s diverticulum was diagnosed and resected. We review the literature, discuss the forms in which the disease presents, the diagnostic modalities utilized, pathological findings, and treatment. Although less than 40 cases have been reported in the English literature from 1978 to 2005, 19 cases have been reported in the last 6 years alone (2006-2012) due to improved diagnostic modalities. Successful diagnosis and treatment of this disease requires a high index of clinical suspicion, which is becoming increasingly relevant to general gastroenterologists.
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Nishikawa T, Takei Y, Tsuno NH, Maeda M. Perforation of Meckel's diverticulum with enteroliths. Clin J Gastroenterol 2012; 5:298-301. [PMID: 26182397 DOI: 10.1007/s12328-012-0313-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2011] [Accepted: 05/14/2012] [Indexed: 11/30/2022]
Abstract
Perforation of Meckel's diverticulum with enteroliths is a rare complication. Here, we report a case of perforation of Meckel's diverticulum with enteroliths, which could be accurately diagnosed by the preoperative computed tomography (CT). A 46-year-old man with acute onset of severe abdominal pain, and a localized muscle guarding in the right hypochondrium, had a solitary stone detected in the right abdomen by the radiography. The abdominal CT revealed a saclike outpouching of the small intestine, containing air/fluid levels and an enterolith, with surrounding free air and mesenteric inflammatory change in the right paraumbilical area. He was diagnosed as the perforation of Meckel's diverticulum with enterolith, and the emergency operation was indicated. The perforated Meckel's diverticulum was identified approximately 90 cm proximal to the ileocecal valve. The diverticulum was transected at the base, and removed. The patient's postoperative course was uneventful. This case strongly suggested the ability of CT enterography to accurately diagnose pathologies involving the small intestine, such as the perforation of Meckel's diverticulum, which open premises for its use in the diagnosis of acute abdomen preoperatively.
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Affiliation(s)
- Takeshi Nishikawa
- Department of Surgery, The Fraternity Memorial Hospital, 2-1-11 Yokoami, Sumida-ku, Tokyo, 130-8587, Japan.
- Department of Surgical Oncology, The University of Tokyo, Tokyo, Japan.
| | - Yoshiki Takei
- Department of Surgery, The Fraternity Memorial Hospital, 2-1-11 Yokoami, Sumida-ku, Tokyo, 130-8587, Japan
| | - Nelson H Tsuno
- Department of Surgical Oncology, The University of Tokyo, Tokyo, Japan
| | - Mamoru Maeda
- Department of Surgery, The Fraternity Memorial Hospital, 2-1-11 Yokoami, Sumida-ku, Tokyo, 130-8587, Japan
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20
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Ihedioha U, Panteleimonitis S, Patel M, Duncan A, Finch G. An unusual presentation of Meckel's diverticulum. J Surg Case Rep 2012; 2012:4. [PMID: 24960808 PMCID: PMC3649513 DOI: 10.1093/jscr/2012.3.4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Meckel's diverticulum can present with unusual symptoms and signs and therefore delay diagnosis. We present the case of a 63 year old lady who presented to the gynaecologists with a huge right sided ovarian cyst. She had required 13 units blood transfusion previously (5 years ago) for massive gastrointestinal bleed with no cause found despite extensive investigations. At operation she was found to have a Meckel's diverticulum in the left lumbar region containing a large calculus. She had an unremarkable post-operative course.
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Affiliation(s)
- U Ihedioha
- Northampton General Hospital, Northampton, UK
| | | | - M Patel
- Northampton General Hospital, Northampton, UK
| | - A Duncan
- Northampton General Hospital, Northampton, UK
| | - Gj Finch
- Northampton General Hospital, Northampton, UK
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21
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[Intestinal obstruction due to Meckel's diverticulum enterolithiasis]. Cir Esp 2011; 90:674-6. [PMID: 22206657 DOI: 10.1016/j.ciresp.2011.06.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2011] [Revised: 05/30/2011] [Accepted: 06/16/2011] [Indexed: 11/22/2022]
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22
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Lai HC. Intestinal obstruction due to Meckel's enterolith. Pediatr Neonatol 2010; 51:139-40. [PMID: 20417467 DOI: 10.1016/s1875-9572(10)60025-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2009] [Revised: 04/30/2009] [Accepted: 05/19/2009] [Indexed: 12/14/2022] Open
Abstract
Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract and represents a persistent remnant of the omphalomesenteric duct. The most common clinical presentation is intermittent and painless rectal bleeding, followed by intestinal obstruction. Intestinal obstruction due to Meckel's enterolith is rarely reported in children. We report a patient who presented with ileus secondary to fecalith impaction of Meckel's diverticulum, causing intestinal obstruction and diverticulitis.
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Affiliation(s)
- Hui-Chien Lai
- Department of Pediatrics, Show Chwan Memorial Hospital, Chang-Hwa, Taiwan.
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23
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Rice RD, Parker DM, Seery JM, Arciero CA. A Small Bowel Obstruction Secondary to a Meckel's Enterolith. Am Surg 2010. [DOI: 10.1177/000313481007600223] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Robert D. Rice
- Dwight David Eisenhower Army Medical Center Fort Gordon, Georgia
| | - David M. Parker
- Dwight David Eisenhower Army Medical Center Fort Gordon, Georgia
| | - Jason M. Seery
- Dwight David Eisenhower Army Medical Center Fort Gordon, Georgia
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24
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Nunes QM, Hotouras A, Tiwari S, Sheth A. Gangrene due to axial torsion of a Giant Meckel's Diverticulum containing multiple stones in the lumen: a case report. CASES JOURNAL 2009; 2:7141. [PMID: 19829920 PMCID: PMC2740251 DOI: 10.1186/1757-1626-2-7141] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2009] [Accepted: 03/03/2009] [Indexed: 11/10/2022]
Abstract
Meckel's diverticulum is the most common congenital anomaly of the small intestine. Common complications related to a Meckel's diverticulum include haemorrhage, intestinal obstruction and inflammation. Gangrene due to axial torsion and enteroliths of a Meckel's diverticulum are the rarest complications that have been reported in the literature. We report a case of gangrene due to axial torsion of giant Meckel's diverticulum with multiple stones in its lumen.
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Affiliation(s)
- Quentin M Nunes
- Department of Surgery, Lincoln County Hospital, Lincoln, UK and 2Department of Histopathology, Lincoln County Hospital,Lincoln, UK.
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25
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Lee MC, Bui JT, Knuttinen MG, Gaba RC, Scott Helton W, Owens CA. Enterolith causing afferent loop obstruction: a case report and literature review. Cardiovasc Intervent Radiol 2009; 32:1091-6. [PMID: 19365684 DOI: 10.1007/s00270-009-9561-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2008] [Revised: 02/28/2009] [Accepted: 03/09/2009] [Indexed: 12/13/2022]
Abstract
Enterolith formation is a rare cause of afferent limb obstruction following Billroth II gastrectomy and Roux-en-Y hepaticojejunostomy surgery. A case of ascending cholangitis caused by an enterolith incarcerated in the afferent loop of a 15-year-old Roux-en-Y hepaticojejunostomy was emergently decompressed under direct ultrasound guidance prior to surgery. This is the thirteenth reported case of an enterolith causing afferent loop obstruction. A discussion of our management approach and a review of the relevant literature are presented.
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Affiliation(s)
- Michael C Lee
- Division of Interventional Radiology (M/C 931), University of Illinois Medical Center, Chicago, IL 60612, USA
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26
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Zarand A, Bajtai A, Baranyai Z, Dede K, Jakab F. Inflammation of ectopic pancreatic tissue in a Meckel's diverticulum causing acute abdominal symptoms: a case report and review of the literature. Int J Surg Pathol 2009; 19:359-63. [PMID: 19223375 DOI: 10.1177/1066896909331995] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
An unusual case of acute abdomen was caused by the inflammation of ectopic pancreatic tissue in a Meckel's diverticulum. A 49-year-old man presented with acute abdominal pain, and the clinical diagnosis of acute appendicitis was established. During laparotomy, a normal appendix of unusual localization near the gallbladder and a Meckel's diverticulum with an inflamed tip were found. Histological examination showed acute inflammation of heterotopic pancreatic tissue along with normal ectopic gastric and duodenal mucosa within the wall of the diverticulum. Fat necrosis was also ascertained. The authors believe that this is the first report of acute inflammation of ectopic pancreatic tissue and the presence of normal ectopic gastric and duodenal tissue in the same Meckel's diverticulum.
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Affiliation(s)
- Attila Zarand
- Department of Surgery and Vascular Surgery, Uzsoki Hospital, Uzsoki Street 29, H-1145 Budapest, Hungary.
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27
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Ehrlich H, Koutsoukos PG, Demadis KD, Pokrovsky OS. Principles of demineralization: Modern strategies for the isolation of organic frameworks. Micron 2008; 39:1062-91. [DOI: 10.1016/j.micron.2008.02.004] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2007] [Revised: 02/08/2008] [Accepted: 02/10/2008] [Indexed: 11/16/2022]
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28
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Katz DS, Yam B, Hines JJ, Mazzie JP, Lane MJ, Abbas MA. Uncommon and Unusual Gastrointestinal Causes of the Acute Abdomen: Computed Tomographic Diagnosis. Semin Ultrasound CT MR 2008; 29:386-98. [DOI: 10.1053/j.sult.2008.06.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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29
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Abstract
Meckel's diverticulum is the most common congenital gastrointestinal anomaly, and 2-4% of patients with a Meckel's diverticulum will subsequently develop complications, including intestinal hemorrhage, intestinal obstruction, and diverticulitis. Meckel's diverticulitis is infrequently included in the differential diagnosis of abdominal pain in older adults. We present a case of Meckel's diverticulitis in a 74 year-old male who presented with non-specific abdominal pain and angina. Here, multi-detector computed tomography (MD-CT) imaging provided a pre-operative diagnosis of Meckel's diverticulitis. We then offer a review of the epidemiology, anatomy, radiologic findings, and differential diagnosis of Meckel's diverticulitis. This case presents coronal and sagittal MD-CT reconstructions of Meckel's diverticulitis that have yet to be well-described in the literature.
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30
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Horlin C, Sergent H, Delhove O, Gilbeau JP. [Meckel's diverticulitis secondary to enterolith]. JOURNAL DE RADIOLOGIE 2006; 87:320-2. [PMID: 16550119 DOI: 10.1016/s0221-0363(06)74009-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
The authors report a case of Meckel diverticulitis secondary to an enterolith in a young man with abdominal pain, fever, and sepsis. In this rare complication, the diagnosis was made, in emergency, on 3D reconstructed images showing the tubular structure connected to the small bowel.
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Affiliation(s)
- C Horlin
- Service de Radiologie, Hôpital de Joliment, Haine-St-Paul, Belgique
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31
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Ueberrueck T, Meyer L, Koch A, Hinkel M, Kube R, Gastinger I. The significance of Meckel's diverticulum in appendicitis--a retrospective analysis of 233 cases. World J Surg 2005; 29:455-8. [PMID: 15776296 DOI: 10.1007/s00268-004-7615-x] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Conflicting reports are found in the literature concerning whether to remove an incidentally discovered Meckel's diverticulum (MD). Between 1.1.1974 and 31.12.2000, at a single center, the perioperative data associated with appendectomy (AE) were recorded consecutively and analyzed retrospectively. All patients in whom an MD was discovered during an AE were included in the study. The clinical presentation, postoperative course, and follow-up in all MDs left in place were analyzed. During the course of 7927 AE, 233 MD (2.9%) were detected. Of these 80.7% (n = 188) were removed and 19.3% (n = 45) were left untouched. In 9% (n = 21) of all detected diverticula pathological changes were found. Ectopic tissue was seen in 12.2% (n = 23) of the MDs removed. The postoperative complication rates did not differ significantly between patients in whom the MD was removed (9.5%; n = 18) and those in whom it was not (17.7%; n = 8); in the latter group the appendicitis was of the more acute type (gangrenous or perforated) (24.4% vs. 4.3%). In 18 patients (40.0%) with non-removed MDs, a follow-up period of 14.1 5.8 years was achieved. Complications associated with a non-removed MD were not observed. If during the course of an AE a MD is detected, the present data, as well as those in the literature, suggest that an individualized approach should be taken. Meckel's diverticulum with obvious pathology should always be removed. In cases of gangrenous or perforated appendicitis, an incidentally discovered MD should be left in place, whereas in an only mildly inflamed appendix it should be removed.
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Affiliation(s)
- Torsten Ueberrueck
- Department of Cardiothoracic and Vascular Surgery, Friedrich-Schiller University, Erlanger-Allee 101, 07747, Jena, Germany.
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32
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Affiliation(s)
- Yu-Meng Tan
- Department of Surgery, Singapore General Hospital, Singapore.
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33
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Levy AD, Hobbs CM. From the archives of the AFIP. Meckel diverticulum: radiologic features with pathologic Correlation. Radiographics 2004; 24:565-87. [PMID: 15026601 DOI: 10.1148/rg.242035187] [Citation(s) in RCA: 166] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Meckel diverticulum is the most common congenital anomaly of the gastrointestinal tract, occurring in 2%-3% of the population. It results from improper closure and absorption of the omphalomesenteric duct. Meckel diverticulum is the most common end result of the spectrum of omphalomesenteric duct anomalies, which also include umbilicoileal fistula, umbilical sinus, umbilical cyst, and a fibrous cord connecting the ileum to the umbilicus. The formation of Meckel diverticulum occurs with equal frequency in both sexes, but symptoms from complications are more common in male patients. Sixty percent of patients come to medical attention before 10 years of age, with the remainder of cases manifesting in adolescence and adulthood. Heterotopic gastric and pancreatic mucosa are frequently found histologically within the diverticula of symptomatic patients. The most common complications are hemorrhage from peptic ulceration, small intestinal obstruction, and diverticulitis. Although the clinical, pathologic, and radiologic features of the complications of Meckel diverticulum are well known, the diagnosis of Meckel diverticulum is difficult to establish preoperatively.
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Affiliation(s)
- Angela D Levy
- Department of Radiologic Pathology, Armed Forces Institute of Pathology, 6825 16th St NW, Washington, DC 20306-6000, USA.
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34
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Gamblin TC, Glenn J, Herring D, McKinney WB. Bowel obstruction caused by a Meckel's diverticulum enterolith: a case report and review of the literature. ACTA ACUST UNITED AC 2004; 60:63-4. [PMID: 14972313 DOI: 10.1016/s0149-7944(02)00650-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Meckel's diverticulum is the most common congenital gastrointestinal anomaly. It may infrequently cause bleeding, perforation, or rarely obstruction. Formation of enteroliths in the diverticulum is uncommon. We present a case of small bowel obstruction from an expelled enterolith.
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Affiliation(s)
- T Clark Gamblin
- Mercer University School of Medicine, Medical Center of Central Georgia, Macon, Georgia, USA
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35
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Barbary C, Tissier S, Floquet M, Régent D. Imagerie des complications du diverticule de Meckel. ACTA ACUST UNITED AC 2004; 85:273-9. [PMID: 15192518 DOI: 10.1016/s0221-0363(04)97578-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Meckel's diverticulum is a persistent embryonic remnant occurring in 2% of the general population. As an "ileal appendix", it is usually clinically silent and only discovered at the time of complications: inflammation, hemorrhage, obstruction, tumor. The preoperative diagnosis is rarely made because of the non specific nature of the symptomatology and only about 10% of complicated cases are diagnosed at imaging. Complications from Meckel's diverticulum should always be considered in patients presenting with an acute abdomen, especially in young adults.
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Affiliation(s)
- C Barbary
- Service de Radiologie, Hôpital d'adultes, CHU Nancy Brabois, rue du Morvan, 54500 Vandoeuvre
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36
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Costa S, Jesús Martínez M, Ripollés T, Delgado F. Diverticulitis de Meckel: hallazgos en ecografía y TC. RADIOLOGIA 2004. [DOI: 10.1016/s0033-8338(04)77944-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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37
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38
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Higginson AP, Hall RI. Meckel's diverticulitis due to an obstructing enterolith: ultrasound and CT appearances. Clin Radiol 2001; 56:593-5. [PMID: 11446760 DOI: 10.1053/crad.2000.0702] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- A P Higginson
- Department of Radiology, Derby City General Hospital, Derby, UK.
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39
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Saenz de Ormijana J, Aisa P, Añorbe E, Olabarría I. Diverticulitis de Meckel perforada con enterolito: diagnóstico mediante ecografía y TC. RADIOLOGIA 2001. [DOI: 10.1016/s0033-8338(01)78006-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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40
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Sánchez Alegre ML, de la Torre J, Guembe P, Alarcón J. Milk of calcium in Meckel's diverticulum. AJR Am J Roentgenol 2000; 174:1466-7. [PMID: 10789817 DOI: 10.2214/ajr.174.5.1741466] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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41
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Affiliation(s)
- H W van Es
- Department of Radiology, St Antonius Hospital, Koekoekslaan 1, 3435 CM Nieuwegein, The Netherlands
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42
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Klingler PJ, Seelig MH, Floch NR, Branton SA, Metzger PP. Small-intestinal enteroliths--unusual cause of small-intestinal obstruction: report of three cases. Dis Colon Rectum 1999; 42:676-9. [PMID: 10344693 DOI: 10.1007/bf02234149] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE The aim of this study was to report on a rare cause of small-intestinal obstruction caused by small-intestinal enteroliths. METHODS We present three different cases of enterolith formation in the small intestine. One occurred after nontropical sprue, one patient had multiple jejunal diverticula, and another patient had enterolith formation in a blind loop after a small-bowel side-to-side anastomosis. RESULTS After initial conservative therapeutic approach all patients underwent surgery. In two patients the enteroliths were removed by ileotomy or jejunostomy. In the third patient the bowel anastomosis had to be revised after removal of the enterolith. CONCLUSION Small-intestinal enteroliths may cause small-bowel obstruction. The first therapeutic approach is nonsurgical; however, if obstruction proceeds, surgical removal with or without revision of underlying pathology is necessary. We discuss the causes and therapeutic management of enteroliths and give a review of related literature.
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Affiliation(s)
- P J Klingler
- Department of General Surgery, Mayo Clinic Jacksonville, Florida, USA
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