Meckel's diverticulum (MD) is the most frequent congenital abnormality of the small bowel and it is often difficult to diagnose. It is usually asymptomatic but approximately 4% are symptomatic with complications such as bleeding, intestinal obstruction, and inflammation. Daniela Codrich et al presents a case of Meckel's diverticulum masked by a long period of intermittent recurrent subocclusive episodes. Their foundings will be published on June 14, 2009 in the World Journal of Gastroenterology.
In this case, a 7-year-old boy presented with repeated episodes of periumbilical pain with associated vomiting which resolved spontaneously in a few hours. The frequency of the episodes increased from one per month to weekly and then daily vomiting, but painless hemorrhage, the classical presenting symptom of Meckel's diverticulum, was never experienced. These symptoms were firstly interpreted as cyclic vomiting of childhood. Only the persistence of the condition accompanied by weight loss prompted physicians to investigate further. A supravesical mass was found with ultrasound and confirmed by magnetic resonance. However, the final diagnosis was only made at laparoscopy.
This article seeks to emphasize that preoperative diagnosis of a complicated Meckel's diverticulum can be challenging and often difficult to establish because clinical symptoms and imaging features overlap with those of other disorders causing acute abdominal pain or gastrointestinal bleeding (in cases where hemorrhage is present). The case also underlines the utmost importance of laparoscopy as a diagnostic and, at the same time, a therapeutic tool in the pediatric population.
Reference: Codrich D, Taddio A, Schleef J, Ventura A, Marchetti F. Meckel's diverticulum masked by a long period of intermittent recurrent subocclusive episodes. World J Gastroenterol 2009; 15(22): 2809-2811 http://www.wjgnet.com/1007-9327/15/2809.asp
Correspondence to: Daniela Codrich, MD, Department of Pediatric Surgery, Institute of Child Health, IRCCS Burlo Garofolo, Trieste. Via dell'Istria 65/1, 34137 Trieste, Italy. firstname.lastname@example.org
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World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H. pylori infection and provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2003-2000 IF: 3.318, 2.532, 1.445 and 0.993. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.
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