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SBA Answers and Explanations
Published in Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury, SBAs for the MRCS Part A, 2018
Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury
Meckel’s diverticulum is the most common congenital abnormality of the small intestine. It is caused by an incomplete obliteration of the vitelline duct. It is present in approximately 2 per cent of the population, with a male predominance. The rule of 2’s may be applied: 2 per cent of the population2 types of ectopic tissue (gastric and pancreatic)2 years of age at time of presentation2 times more common in males to be affected
Abdominal emergencies
Published in Sam Mehta, Andrew Hindmarsh, Leila Rees, Handbook of General Surgical Emergencies, 2018
Sam Mehta, Andrew Hindmarsh, Leila Rees
A Meckel’s diverticulum may present with: diverticulitis: which mimics appendicitis44peptic ulcerationhaemorrhage: the most common cause of lower GI haemorrhage in paediatric patientsintussusception: acts as a leadpointobstruction: caused by a band between the diverticulum and the umbilicus.
Gastrointestinal system
Published in Aida Lai, Essential Concepts in Anatomy and Pathology for Undergraduate Revision, 2018
Meckel’s diverticulum Congenital diseaseRemnant of vitelline duct of embryo (connects yolk sac to midgut)Rule of twos: occurs in 2% of population, 2 feet from ileo-caecal valve, mostly 2 inches longMost patients are asymptomatic (2% are symptomatic), and the main complaint is of painless rectal bleedingMostly incidental findingsComplications: – bleeding– intestinal obstruction– formation of fistulaManagement: – surgical resection (if bleeding or obstruction occurs)
Continuous midazolam infusion can minimize the pro-inflammatory response to anesthesia and surgery for pediatric patients with intra-abdominal infection: Comparative study versus continuous propofol infusion
Published in Egyptian Journal of Anaesthesia, 2021
Mohamed A. Lotfy, Mohamed G. Ayaad, Mohamed I. Elsawaf, Gehan F. Atyia
Acute abdominal pain in pediatric patients is mostly secondary to acute appendicitis, which is one of the most frequent emergencies in pediatric surgery [1]. Intussusception is the most common cause of acute abdominal pain due to small bowel obstruction in children under 4 years [2]. Surgery remains the mainstay in treating intussusception especially when non-operative reduction is contraindicated or unsuccessful [3] and may involve manual reduction only or bowel resection for bowel necrosis, perforation or irreducibility [4]. Meckel’s diverticulum is a congenital malformation that can be complicated with intestinal obstruction, diverticulitis or perforation [5]. In general, intra-abdominal sepsis causes disruption of gut microcirculation with subsequent tissue hypoxia, and the damaged gut acts as reservoir for inflammatory mediators and provides a continual source of these mediators to the systemic circulation [6].
Meckel’s diverticulum in an adult with iron deficiency
Published in Baylor University Medical Center Proceedings, 2021
Gowthami Kanagalingam, Vrinda Vyas, Anuj Sharma, Divey Manocha
Small bowel capsule endoscopy showed a nonobstructing oozing frond-like pedunculated polyp in the distal ileum (Figure 1). Subsequently, the patient underwent a laparoscopic-assisted small bowel resection. Intraoperatively, a 4.5-cm bleeding polypoid lesion was seen in the distal ileum. Histopathology of the resected segmental small intestine confirmed the presence of a Meckel’s diverticulum with focal mucosal ulceration and inflammation. This confirmed the presentation of a Meckel’s diverticulum as a bleeding polypoid lesion in the small bowel capsule endoscopy and intraoperatively. Her blood work 3 months after surgery showed a normal iron profile with resolution of her symptoms.