Meckel's diverticulum: an incidental finding
Keywords:
divertículo de Meckel, tejido ectópico, anomalía congénita.Abstract
Background: Meckel's diverticulum is a congenital anomaly with a low incidence and prevalence. The majority of patients who present it are asymptomatic and are diagnosed incidentally, however about 2% of individuals develop a complication throughout their lives, but as these tend to decrease as age progresses, it is very rare to diagnose it in adults.
Objective: to describe the presentation of a Meckel diverticulum in an adult patient found incidentally during the autopsy.
Case report: a 66-year-old male patient who, upon performing the autopsy study, revealed the presence of a diverticular sac 62 cm from the ileocecal valve, which revealed the presence of areas of ectopic gastric mucosa in the histological study with hematoxylin and eosin.
Conclusions: Meckel's diverticulum is a congenital anomaly that is frequently located 60 cm from the ileocecal valve, on the anti-mesenteric edge; 50% of them contain ectopic tissue; and its diagnosis is made in most cases incidentally.
DeCS: MECKELS DIVERTICULUM; CASE REPORTS; AUTOPSY; CONGENITAL ABNORMALITIES; CHORISTOMA.
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1. Pepper VK, Stangill AB, Pearl RH. Diagnosis and management of pediatric apendicitis, intussusception, and Meckel diverticulum. Surg Clin N Am [Internet]. 2012 Jun [citado 20 Jul 2019];92(3):[aprox. 22 p.]. Disponible en: https://pubmed.ncbi.nlm.nih.gov/22595706/.
2. Morales JL, Olmos de Aguilera R, Sánchez C, Sáez D. Divertículo de Meckel volvulado asociado a brida como causa de obstrucción en intestino delgado. Rev Chil Cir [Internet]. Ago 2018 [citado 20 Jul 2019];70(4). Disponible en: https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0718-40262018000400358&lang=pt
3. Kuru S. Meckel's diverticulum: clinical features, diagnosis and management. Rev esp enferm dig [Internet]. 2018 Nov [citado 20 Jul 2019];110(11). Disponible en: https://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082018001100008
4. Khedr S, Jazaerly T, Kostadinov S. Placental Teratoma, Omphalomesenteric Duct Remnant, or Intestinal Organoid (Enteroid) Differentiation: A Diagnostic Dilemma. J Pediatr Genet [Internet]. 2017 Dic [citado 20 Jul 2019];6(4):[aprox. 6 p.]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5683956/.
5. Shelat VG, Li KK, Rao A, Guan TS. Meckel’s diverticulitis causing small bowel obstruction by a novel mechanism. Clin Pract [Internet]. 2011 Jul [citado 20 Jul 2019];1(3):e51. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3981389/.
6. Ghritlaharey RK. Meckel’s Diverticulum and Patent Vitelline Duct in Children. [Internet]. India: SMGroup; 2014 [citado 20 Jul 2019]. Disponible en: https://smjournals.com/ebooks/general-pediatric/chapters/GPS-14-01.pdf
7. Ruíz Celorio M, Higuera de la Tijera F, Pérez Torres E. El divertículo de Meckel. Rev Med Hosp Gen Méx [Internet]. Abr 2014 [citado 20 Jul 2019];77(2):[aprox. 5 p.]. Disponible en: https://www.elsevier.es/en-revista-revista-medica-del-hospital-general-325-articulo-el-diverticulo-meckel-X0185106314366094
8. Blouhos K, Boulas KA, Tsalis K, Barettas N, Paraskeva A, Kariotis I, et al. Meckel's Diverticulum in Adults: Surgical Concerns. Front Surg [Internet]. 2018 Sep [citado 20 Jul 2019];5:55. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6129587/.
9. Puentes JA, Salcedo JD, Luna DR. Divertículo de Meckel en el adulto mayor: una causa de sangrado digestivo. Revisión de la literatura y reporte de un caso. Rev Colomb Cir [Internet]. 2015 [citado 20 Jul 2019];30: [aprox. 5 p.]. Disponible en: https://www.revistacirugia.org/index.php/cirugia/article/view/325/300
10. Barrera Lozano LM, Vélez Román JC, Londoño Schimmer EE, López Panqueva RP. Divertículo de Meckel en el paciente adulto. Experiencia en la Fundación Santa Fe de Bogotá. Rev Col Gastroenterol [Internet]. Sep 2005 [citado 20 Jul 2019];20(3). Disponible en: http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0120-99572005000300004
11. Park JJ, Wolff BG, Tollefson MK, Walsh EE, Larson DR. Meckel diverticulum: The Mayo Clinic experience with 1476 patients (1950-2002). Ann Surg [Internet]. 2005 Mar [citado 20 Jul 2019];241(3):[aprox. 5 p.]. Disponible en: https://pubmed.ncbi.nlm.nih.gov/15729078/.
12. Motta-Ramírez GA, Reyes-Méndez E, Campos-Torres J, García-Ruiz A, Rivera-Méndez VM, García-Castellanos JA, et al. El divertículo de Meckel en adultos. An Rad Mex [Internet]. 2015 [citado 20 Jul 2019];14:[aprox. 10 p.]. Disponible en: https://www.medigraphic.com/pdfs/anaradmex/arm-2015/arm151c.pdf
13. Moszkowicz D, Massalou D, Voiglio EJ. Cirugía del divertículo ileal. EMC-Técnicas quirúrgicas [Internet]. Nov 2015 [citado 20 Jul 2019];31(4):[aprox. 10 p.]. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S128291291574153X
14. Choi SY, Hong SS, Park HJ, Lee HK, Shin HC, Choi GC. The many faces of Meckel's diverticulum and its complications. J Med Imaging Radiat Oncol [Internet]. 2017 Abr [citado 20 Jul 2019];61(2): [aprox. 7 p.]. Disponible en: https://onlinelibrary.wiley.com/doi/full/10.1111/1754-9485.12505
15. Sandoval Garcia MA, Rocha Millan J, Pineda Bahena LG, Ferreiro Marin A. Divertículo de Meckel, ¿un reto diagnóstico? An Med (Mex) [Internet]. 2016 [citado 20 Jul 2019];61(1):[aprox. 5 p.]. Disponible en: https://www.medigraphic.com/pdfs/abc/bc-2016/bc161m.pdf
16. Sagar J, Kumar V, Shah DK. Meckel's diverticulum: a systematic review. J R Soc Med [Internet]. 2006 Oct [citado 20 Jul 2019];99(10):[aprox. 5 p.]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1592061/.
17. Fernández Santiesteban LT, Goicolea Ramirez LR, Romanidy Cervantes C. Obstrucción intestinal por fitobezoar en un divertículo de Meckel. Rev Cubana Cir [Internet]. Abr-Jun 2014 [citado 20 Jul 2019];53(2). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034-74932014000200009
18. Lequet J, Menahem B, Alves A, Fohlen A, Mulliri A. Meckel’s diverticulum in the adult. J Visc Surg [Internet]. 2017 Sep [citado 20 Jul 2019];154(4):[aprox. 7 p.]. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S1878788617300620
19. Escarra JM, Fraccalvieri D, Paules Villar MJ, Kreisler Moreno E. Tumor neuroendocrino en divertículo de Meckel: un hallazgo inusual. Cir Esp [Internet]. Dic 2015 [citado 20 Jul 2019];93(10):[aprox. 2 p.]. Disponible en: https://www.elsevier.es/es-revista-cirugia-espanola-36-articulo-tumor-neuroendocrino-diverticulo-meckel-un-S0009739X14002383
20. Gutiérrez Naranjo M. Divertículo de Meckel. Rev med Costa Rica y Centroamerica [Internet]. 2012 [citado 20 Jul 2019];69(604):[aprox. 5 p.]. Disponible en: https://www.medigraphic.com/pdfs/revmedcoscen/rmc-2012/rmc125j.pdf
21. Flórez Leguía MK, Valencia JJ, Sierra Sierra S. Tumor neuroendocrino en un divertículo de Meckel. Rev CES Med [Internet]. 2018 [citado 20 Jul 2019];32(3): [aprox. 7 p.]. Disponible en: http://www.scielo.org.co/pdf/cesm/v32n3/0120-8705-cesm-32-03-294.pdf
22. Varcoe RL, Wong SW, Taylor CF, Newstead GL. Diverticulectomy is inadequate treatment for short Meckel's diverticulum with heterotopic mucosa. ANZ J Surg [Internet]. 2004 Oct [citado 20 Jul 2019];74(10):[aprox. 4 p.]. Disponible en: https://pubmed.ncbi.nlm.nih.gov/15456435/.
23. Mukai M, Takamatsu H, Noguchi H, Fukushige T, Tahara H, Kaji T. Does the external appearance of a Meckel's diverticulum assist in choice of the laparoscopic procedure? Pediatr Surg Int [Internet]. 2002 May [citado 20 Jul 2019];18(4):[aprox. 3 p.]. Disponible en: https://pubmed.ncbi.nlm.nih.gov/12021967/.
24 Juanmartiñena Fernández JF, Fernández Urién-Sainz I, Saldaña Dueñas C, Iglesias Picazo R. Meckel’s diverticulum bleeding detected by capsule endoscopy. Rev Esp Enferm Dig [Internet]. 2017 [citado 20 Jul 2019];109(4):[aprox. 2 p.]. Disponible en: https://scielo.isciii.es/pdf/diges/v109n4/imagen11.pdf
25. Krstic SN, Martinov JB, Sokic-Milutinovic AD, Milosavljevic TN, Krstic MN. Capsule endoscopy is useful diagnostic tool for diagnosing Meckel’s diverticulum. Eur J Gastroenterol Hepatol [Internet]. 2016 Jun [citado 20 Jul 2019];28(6):[aprox. 5 p.]. Disponible en: https://pubmed.ncbi.nlm.nih.gov/26854797/.
26. Chatterjee A, Harmath C, Lopes Vendrami C, Hammond NA, Mittal P, Salem R, et al. Reminiscing on Remnants: Imaging of Meckel Diverticulum and Its Complications in Adults. AJR Am J Roentgenol [Internet]. 2017 Nov [citado 20 Jul 2019];209(5):[aprox. 10 p.]. Disponible en: https://pubmed.ncbi.nlm.nih.gov/28834452/.
27. Payeras Capó MA, Ambrona Zafra D, Garrido Durán C. Divertículo de Meckel invertido en paciente adulto diagnosticado por cápsula endoscópica. Rev Esp Enferm Dig [Internet]. 2018 [citado 20 Jul 2019];110(3):[aprox. 10 p.]. Disponible en: https://scielo.isciii.es/pdf/diges/v110n3/1130-0108-diges-110-03-00210.pdf
28. Lohsiriwat V, Sirivech T, Laohapensang M, Pongpaibul A. Comparative study on the characteristics of Meckel’s diverticulum removal from asymptomatic and symptomatic patients: 18-year experience from Thailand’s largest university hospital. J Med Assoc Thai [Internet]. 2014 May [citado 20 Jul 2019];97(5):[aprox. 6 p.]. Disponible en: https://www.researchgate.net/publication/264290340_Comparative_study_on_the_characteristics_of_Meckel%27s_Diverticulum_removal_from_asymptomatic_and_symptomatic_patients_18-year_experience_from_Thailand%27s_largest_
University_Hospital
29. Zani A, Eaton S, Rees CM, Pierro A. Incidentally detected Meckel diverticulum: to resect or not to resect? Ann Surg [Internet]. 2008 Feb [citado 20 Jul 2019];247(2):[aprox. 6 p.]. Disponible en: https://pubmed.ncbi.nlm.nih.gov/18216533/.
30. Zulfikaroglu B, Ozalp N, Zulfikaroglu E, Ozmen MM, Tez M, Koc M. Is incidental Meckel's diverticulum resected safely? N Z Med J [Internet]. 2008 Sep [citado 20 Jul 2019];121(1282):[aprox. 6 p.]. Disponible en: https://pubmed.ncbi.nlm.nih.gov/18815602/.
31. Robijn J, Sebrechts E, Miserez M. Management of incidentally found Meckel's diverticulum a new approach: resection based on a Risk Score. Acta Chir Belg [Internet]. 2006 Jul-Ago [citado 20 Jul 2019];106(4):[aprox. 4 p.]. Disponible en: https://pubmed.ncbi.nlm.nih.gov/17017710/.
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