A Rare Cause of Abdominal Pain in Adults: Meckel ’s Diverticulitis

A 42-year-old man presented to the emergency room with complaints of periumbilical abdominal pain. A contrast-enhanced computed tomography revealed mucosal thickening in the small bowel of the right abdomen. There was a fairly large small bowel diverticulum associated with this segment. Findings were suggestive of small bowel diverticulitis or possibly focal enteritis. A Meckel ’s diverticulum scan was diagnostic of Meckel’s diverticulum. The patient was then immediately taken to the operating room for emergency laparotomy and was intra-operatively found to have a thickened Meckel’s diverticulitis with adjacent small bowel obstruction. Meckel’s diverticulectomy was performed in continuity with the adjacent inflamed small bowel. The patient had a stable postoperative course without any complications and was discharged within 10 days. At the 3-month follow-up, the patient was well and remained asymptomatic.Case Rep Gastroenterol 2018;12:709 –714
Source: Case Reports in Gastroenterology - Category: Gastroenterology Source Type: research

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Abstract BACKGROUND: Two RCTs (AVOD and DIABOLO) demonstrated no difference in recovery or adverse outcomes when antibiotics for acute uncomplicated diverticulitis were omitted. Both trials showed non-significantly higher rates of complicated diverticulitis and surgery in the non-antibiotic groups. This meta-analysis of individual-patient data aimed to explore adverse outcomes and identify patients at risk who may benefit from antibiotic treatment. METHODS: Individual-patient data from those with uncomplicated diverticulitis from two RCTs were pooled. Risk factors for adverse outcomes and the effect of observ...
Source: The British Journal of Surgery - Category: Surgery Authors: Tags: Br J Surg Source Type: research
CASE SUMMARY: A 62-year-old previously healthy man presented with left lower quadrant pain and fever. Physical examination showed left lower quadrant peritonitis. Computed tomography scan showed a pelvic abscess with extraluminal air (Fig. 1). Intravenous antibiotics were started, and CT-guided percutaneous drainage was performed. The drain was removed 1 week after discharge. One week later, he presented with dysuria and pneumaturia and was started on antibiotics. Colonoscopy confirmed diverticulosis with no other mucosal abnormalities. He underwent a successful laparoscopic sigmoidectomy with colovesical fistula takedown.
Source: Diseases of the Colon and Rectum - Category: Gastroenterology Tags: Resident’s Corner Source Type: research
We present a case of a symptomatic large rectal diverticulum presenting with a retrorectal abscess. A 49-year-old Caucasian female was brought to the emergency department complaining of abdominal pain and weakness in the lower limbs. She was found to have obstructive uropathy and unilateral sciatic neuropathy. She rapidly developed acute abdomen and emergency laparotomy revealed a giant purulent rectal diverticulum. The patient underwent exploratory laparotomy and a loop colostomy was made to decompress the colon.
Source: Annals of Medicine and Surgery - Category: General Medicine Source Type: research
A 58-year-old woman with enlarging fibroid uterus in menopause presented for gynecologic evaluation. The enlarging, pedunculated, exophytic fibroid measuring 8.7  × 10 × 10 cm was noted incidentally on CT performed for an episode of acute abdominal pain attributed to diverticulitis. Three years earlier, the fibroid measured 4.0 × 4.2 × 3.9 cm on transvaginal ultrasound. Given the concern for an enlarging fibroid in menopause, MRI was perf ormed which showed a pedunculated fundal fibroid measuring 8.5 × 7.2 × 9.2 cm and progressively enhancing right ovarian cyst me...
Source: The Journal of Minimally Invasive Gynecology - Category: OBGYN Authors: Tags: Images in Gynecological Surgery Source Type: research
A 58-year-old woman with an enlarging uterine myoma in menopause presented for gynecologic evaluation. The enlarging, pedunculated, exophytic myoma measuring 8.7  × 10 × 10 cm was noted incidentally on computed tomography performed for an episode of acute abdominal pain attributed to diverticulitis. Three years earlier, the myoma measured 4.0 × 4.2 × 3.9 cm on the transvaginal ultrasound. Given the concern for an enlarging myoma in menopa use, magnetic resonance imaging was performed, which showed a pedunculated fundal myoma measuring 8.5 × 7.2 × 9.2 cm and a prog...
Source: The Journal of Minimally Invasive Gynecology - Category: OBGYN Authors: Tags: Images in Gynecologic Surgery Source Type: research
ConclusionClinician awareness must be heightened for perforating CD in the setting of abscess refractory to either multiple drainage procedures, although care should be taken to individualize treatment to each CD patient who presents with an abdominal abscess.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
ConclusionAlthough Meckel’s diverticulitis is a rare entity, it can appear as an acute abdomen. An early diagnosis and treatment to prevent subsequent complications is essential to ensure an optimal recovery.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
CONCLUSIONS: Our results indicated showed that the supplement with the probiotic mix of Bifidobacterium lactis LA 304, Lactobacillus salivarius LA 302, and Lactobacillus acidophilus LA 201 in combination with the standard antibiotic therapy for AUD reduced abdominal pain and inflammation significantly more than antibiotic treatment used alone. These findings could be due to the anti-inflammatory activity of the probiotic mix. Larger studies are needed to validate its use in the clinical practice. PMID: 31696504 [PubMed - in process]
Source: European Review for Medical and Pharmacological Sciences - Category: Drugs & Pharmacology Tags: Eur Rev Med Pharmacol Sci Source Type: research
CONCLUSIONAlthough Meckel's diverticulitis is a rare entity, it can appear as an acute abdomen. An early diagnosis and treatment to prevent subsequent complications is essential to ensure an optimal recovery.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
Diverticulitis is one of the most common and costly gastrointestinal disorders, primarily presenting in older adults [1 ⿿6]. Diverticulitis is a complication of diverticulosis, a condition defined by the presence of colonic diverticula, which are mucosal herniations in the muscle layer of the colon wall [7]. Diverticulosis can present itself as asymptomatic (AS) diverticular disease or as symptomatic uncomplicated diverticular disease (SUDD). SUDD differs from AS in that the herniations are associated with persistent gastrointestinal symptoms (GIS) similar to that of irritable bowel syndrome, such as flatulence, pain, fa...
Source: Maturitas - Category: Primary Care Authors: Source Type: research
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