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Content available remote Surgical Treatment of Meckel's Diverticulum
The aim of the study. Assessment of own research material associated with surgical treatment of Meckel's diverticulum (MD).Material and methods. Retrospective analysis of medical records of 27 patients managed in the Department of Endocrine and General Surgery of Medical University in Łódź between 1st October 2002 and 31st December 2009 due to incidentally found during surgery and not producing symptoms MD and also operated on for its complications.Results. After excision of MD causing symptoms surgical complications possibly directly associated with the removal of MD were not observed. After prophylactic excision of MD such complications occurred in 2 patients (11.11%). Moreover, in this group we found one death after the operation, but it was not attributable to performed diverticulectomy and was caused by multiple coexisting diseases. In 3 of 14 prophylactically removed and macroscopically normal Meckel's diverticula the presence of reactive inflammation was diagnosed on histopathology.Conclusions. Excision of MD, both producing symptoms and incidentally found, is associated with the low risk of complications. After the recognition of acute appendicitis all identified Meckel's diverticula should be removed, even macroscopically normal, because they can present with the reactive inflammatory process. The method of MD excision depends on intraoperative diagnosis. The risk of MD-related complications may increase with age.
Content available remote Meckel's Diverticulum Incarcerated in an Umbilical Hernia - Case Report
Hernias containing incarcerated Meckel's diverticulum are rare and often asymptomatic. The proper preoperative diagnosis is difficult to establish. The presence of a Meckel's diverticulum incarcerated in a hernia should be consider in a differential diagnosis of abdominal disease that is not sufficiently apparent. We present a case of a 22 years old male patient with a Meckel's diverticulum incarcerated in an umbilical hernia.
Meckel's diverticulum is the most common congenital abnormality of alimentary tract. The antimesenteric location is one of the cardinal attribiutes of this pathology. We report case which tries to verify this dogma. The literature regarding uncommon location of Meckel's diverticulum was also reviewed.
Content available remote Intussuception at Atypical Ages in Children and Adults - 11 Years Experiences
Intussusception is a curious anatomic condition characterized by the invagination of one segment of the gastrointestinal tract into the lumen of an adjacent segment. Once initiated, additional intestinal telescopes into the distal segment, causing the invaginated intestine to propagate distally within the bowel lumen.The aim of the study was to evaluate the clinical manifestation, etiology, and outcome of intussuception at atypical ages.Material and methods. This retrospective study was carried out on patients aged <6 mo or >2 yr with intussusception. Duration of study was from March, 20, 1997 to March, 20, 2008. The places of study were Imam Khomeini and Abuzar referrals hospital. Cases were classified according to age and sex. According to age, patients were <6 mo, 2-10 years, 10-18, and more than 18 years. Age, sex, history, chief complaint, clinical manifestation, sonographic findings, duration of clinical manifestation, method of treatment, outcome, duration of hospital staying, and ICU admission were studied. Data were analyzed with SPSS ver 16 (Chicago, IL, USA) and Epi-info.Results. In this study, 36 cases with diagnosis of intussusception at atypical ages, <6 mo or >2 yr, were included. From all cases, 21 cases (58.3%) were 2 through 10 years and male: female ratio was 2.26:1. Ten cases (27.8%) had history of medical condition. Eighty percent (29 cases) had abdominal pain and 20 cases (58.3%) had vomiting. Abdominal mass was found in 14 cases (38.8%). Sonography was done for 30 (83.3%) of cases and suggesting intussuception in 25 (69.4%) of cases. Intussuception was reduced by hand and performed appendectomy for 10 cases (27.8%). Bowel resection was done for 19 cases (52.8%) and radiological reduction was done for 2 cases (5.6%). Eighteen (50%) cases had anemia. Twenty-five cases admitted to ICU. One (2.8%) patient died (a 65 year old woman). Appendicitis is the most common well defined injury associated with intussusception.Conclusion. This study showed that with advancing age, incidence of intussusception will be decreased. As age increasing, rate of bowel resection will be increased. All cases with appendectomy and reduction by hand had hospital staying 3-10 days. The results of this study was similar to other studies. The most widely used diagnostic procedure for intussusception was sonography.
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