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Abstract
Meckel's diverticulum is a cause of significant morbidity and mortality. Often this
is related to the delay in diagnosis. Based on a US population of 200 million people
and a 2% incidence, there are 4 million Meckel's diverticula present waiting to cause
symptoms. Considering that most Meckel's diverticula are asymptomatic and that many
authors have described the condition as a great mimic, the diagnosis is often quite
elusive. Therefore, a high index of suspicion is needed to diagnose Meckel's diverticulum
correctly and expeditiously as the source of disease in the patient with an often
unclear abdominal presentation. The difficulty with diagnosis should be lessened if
one considers that Meckel's diverticulum presents largely in the male and younger
age groups with the three major symptom complexes of bowel obstruction, gastrointestinal
bleeding, and inflammation. Use of 99mTc pertechnetate scintigraphy appears to be the diagnostic study of choice if Meckel's
diverticulum is suspected and the patient is clinically stable. When one considers
the potential for bad outcome if Meckel's diverticulum is missed in the setting of
possible obstruction or hemorrhage (i.e., bowel infarction or exsanguination), a high
index of suspicion and diagnostic aggressiveness is warranted. Lastly, if one thought
is to be left behind, it should be: “Meckel's is a great mimic that must be considered
in all cases of intra-abdominal disease in which the cause is not readily apparent.”7
Keywords
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References
- Meckel's diverticulum in an umbilical hernia.Br J Surg. 1970; 57: 932-933
- The incidence of hernia in the United States.Ind Med Surg. 1962; 31: 19-21
- Meckel's diverticulum: intestinal obstruction due to invagination and intussusception: peritonitis due to perforation by fish bone. 1941; 15: 296-300
- Histiologic study of Meckel's diverticulum with special reference to heterotopic tissue.Arch Surg. 1936; 32: 506-523
- Thesarus Anatomicusis. vol 7. J Wotters, Amsterdam1701: 44 ed 8.
- Meckel's diverticulum: clinical and histologic study.Acta Chir Scand. 1959; 248 (quoted by Soderlund S) (Suppl): 1-233
- Meckel's diverticulum: fifty-five years of clinical and surgical experience.JAMA. 1962; 182: 131-133
- Meckel's diverticulum in the adult.Br J Surg. 1986; 73: 146-149
- Radionuclide detection of gastrointestinal bleeding.Am Fam Physician. 1982; 25: 191-194
- Meckel's diverticulum: a review of 148 pediatric patients, with special reference to the pattern of bleeding and to mesodiverticular vascular bands.Surgery. 1966; 59: 618-626
- Malabsorption secondary to Meckel's diverticulum.Am J Surg. 1982; 144: 588-592
- Unusual Meckel's diverticulum as a cause of intestinal hemorrhage.Am J Dis Child. 1928; 36: 1218-1223
- Surgical emergencies during childhood caused by Meckel's diverticulum.Ann Surg. 1941; 113: 47-56
- Giant Meckel's diverticulum,Br J Surg. 1926; 14: 176-179
inches long.
- Elongated Meckel's diverticulum in a child.Am J Dis Child. 1938; 55: 128-134
- A fifty year experience with Meckel's diverticulum.Surg Gynecol Obstet. 1983; 156: 56-64
- Perforationsperitonitis von einem darmdivertikel mit magenschleimhautbau ausgehend.Dtsch Z Chir. 1907; 88: 482-493
- Littre's umbilical hernia.Am J Surg. 1943; 60: 81-87
- Meckel's diverticulum in children: a report of 43 cases.Br J Surg. 1954; 42: 57-68
- Meckel's diverticulum.Br J Surg. 1961; 48: 392-399
- Strangulated hernia of Meckel's diverticulum in an infant.J Pediatr Surg. 1966; 1: 579-582
- The natural history of Meckel's diverticulum and its relation to incidental removal: a study of 202 cases of diseased Meckel's diverticulum found in King County, Washington, over a fifteen year period.Am J Surg. 1976; 132: 168-173
- Meckel's diverticulum: investigation of 600 patients in the Japanese literature.Am J Surg. 1978; 136: 247-249
- Complications of Meckel's diverticulum.Br J Surg. 1976; 63: 453-454
- Gastrointestinal bleeding in children.Surg Clin North Am. 1985; 65: 1455-1481
- Severe lower intestinal bleeding: diagnosis and treatment.Clin Gastroenterol. 1981; 10: 65-91
- Meckel's diverticulum in childhood: a review of 73 cases.Postgrad Med. 1963; (Oct:): 341-348
- Das Meckelsche divertikel.Ergeb Chir Orthop. 1937; 30 (quoted by Neff G): 227-315
- Meckel's diverticulum, a report of two unusual cases.N Engl J Med. 1947; 237: 118-122
- Neoplasms of Meckel's diverticulum.Int Abstracts Surg. 1963; 116: 103-111
- The natural history of Meckel's diverticulum and its relation to incidental removal.Am J Surg. 1976; 132 (in discussion of Soltero MJ, Bill AH): 168-173
- Über die entzündung des meckelschen divertikels und die gangrän desselben.Dtsch Z Chir. 1902; 62: 523-547
- Some acute abdominal conditions in childhood.Miss Doctor. 1938; 15: 43-50
- Massive hematemesis and melaena from a Meckel's diverticulum.Postgrad Med J. 1983; 59: 786-787
- Specificity of 99mTc pertechnetate in scintigraphic diagnosis of Meckel's diverticulum: review of 100 cases.J Nucl Med. 1976; 17: 465-469
- Radiopertechnetate imaging of the Meckel's diverticulum.Radiology. 1972; 105: 371-373
- Meckel's diverticulum: serial view imaging.J Nucl Med. 1976; 17: 553
- The sensitivity, specificity and accuracy of radionuclide imaging of Meckel's diverticulum.J Nucl Med. 1976; 17: 553
- Abdominal scanning for bleeding Meckel's diverticulum using 99mTc pertechnetate.Aust Paediatr J. 1978; 14: 244-247
- Radionuclide imaging of Meckel's diverticulum in children.Clin Nucl Med. 1978; 3: 4-8
- Abdominal scintigraphy for ectopic gastric mucosa: a retrospective analysis of 143 studies.AJR. 1982; 138: 7-12
- Technetium pertechnetate scintigraphy to detect ectopic gastric mucosa in Meckel's diverticulum.Acta Radiol (Diagn) (Stockh). 1984; 25: 417-422
- Meckel's diverticulum.Semin Nucl Med. 1982; 12: 97-98
- Pentagastrin stimulation of Tc 99m uptake by ectopic gastric mucosa in a Meckel's diverticulum.Radiology. 1978; 128: 711-712
- Pentagastrin: a new drug for stimulating gastric secretion of pertechnetate.J Nucl Med. 1975; 16: 535-536
- Effect of pentagastrin, histalog, glucagon, secretion and perchlorate on the gastric handling of 99m Tc pertechnetate in mice.Radiology. 1976; 120: 629-631
- Cimetidine administration resulting in improved pertechnetate imaging of Meckel's diverticulum.Clin Nucl Med. 1978; 3: 385-388
Article Info
Publication History
Accepted:
June 9,
1987
Received:
May 8,
1987
Identification
Copyright
© 1988 Published by Elsevier Inc.