Meckel diverticula

Meckel diverticula Meckel Diverticolul is an embryonic rest, the finger glove of the intestinal wall at the junction of the small intestine and has the same structure colon.Acesta intestinal wall, but is attached hereto, consisting of gastric and pancreatic tissue. Approximately 3% of children are born with Meckel.Acesta diverticulum can remain asymptomatic for a long period of time. In half the cases it contains structures gastric or pancreatic tissue is present ambele.Daca gastric acid secretion that cause ulcers and bleeding intestinale.Diverticulul may swell causing diverticulitis. The age at which symptoms may occur is 2 years, children over 10 years rarely shows symptoms. The most common clinical manifestation is the externalization of dark blood through rect.Hematochezia may contain digested blood-black oil, the odor, or partially digested red roz.Durerea is not usually present, although some children may experience pain abdominal. Treatment consists of excision of diverticula.
Pathogenesis Meckel diverticula is a remnant of the embryonic duct that connects the primitive digestive tract in fetal life and normally this bag vitelin.In fibrozeaza duct is progressively disappears in the seventh week of gestation, if it is incomplete obliteration, different types of structures appear abnormal bowel . Examples of these include: persistent yolk duct (appears as an umbilical fistula), fibrous band that connects the intestine from the inside of the navel, a sinus yolk subombilical, canceled a portion of the intestine, an intestinal cyst or Meckel diverticolul most common. Enterochistii, umbilical sinus and fistula omfaloileale associated congenital anomalies are among the Meckel diverticulum. Diverticolul omfalomezenterica artery is vascularized, rest viteline.Localizarea most common artery is 40 cm proximal to the ileocaecal valve. It is 3 inches long and 2-lai cm.Contine ectopic gastric or pancreatic mucosa. In 75% of the cases is attached to the anterior abdominal wall or other internal structure.
Signs and symptoms Classical clinical presentation in children is the externalization of blood through the anus in patients less than 2 ani.Majoritatea cases are pediatric patients ages 2 to 8 years. In adults, obstruction and inflammation are more frequent than hematochezia.Totusi many patients are asymptomatic and incidentally discovered diverticula is barytic radiological study or laparotomy. Symptomatic Meckel diverticula is synonymous with clinical complication. Other symptoms may be encountered and abdominal pain, vomiting, sensitivity to palpation. Meckel diverticulum complications include: -Bowel obstruction -Umbilical fistula -Diverticulitis -Severe bleeding. In rare cases, benign tumors may develop: angioma, leiomioame, neuroma, lipoma, or malignant tumors: sarcoma, carcinoma, adenocarcinoma. Diverticula may be perforated bone fish or fruit seeds.
Diagnosis Laboratory studies that may make diagnosis of Meckel diverticulum may include: Low-hematocrit and hemoglobin in cases of hemorrhagic anemia Vitamin B12-deficient megaloblastic anemia -Low levels of ferritin and albumin-inflammation diverticulum -Test-scan imaging with technetiu99 -Selective arteriography Barium-radiological tests -Ultrasound -Computed tomography.
Treatment Treatment involved surgical excision of the diverticula complicated. The blood into the artery should be identified and ligaturata.Daca diverticula patient presented after a severe rectal bleeding, hemodynamically stabilize it. As to the surgical therapy is folosecs additional antibiotics: ampicillin, clindamicinagentamicina, cefotetan, drugs with broad spectrum antimicrobial. Complicated Meckel diverticula can have a high morbidity rate, mainly due to delay in diagnostic.O Once installed complication and surgical intervention is required, mortality and morbidity increased to 12%. Long-term risk of death after surgery is 7% . If the diverticula is removed after it was discovered incidentally, long-term risk of death is 1%.