Meckel's diverticulum history and symptoms: Difference between revisions
No edit summary |
|||
| Line 43: | Line 43: | ||
Less common [[Symptom|symptoms]] of Meckel's diverticulum arise in complicated cases: | Less common [[Symptom|symptoms]] of Meckel's diverticulum arise in complicated cases: | ||
*Symptoms of [[intussusception]], particularly recurrent or atypical [[intussusception]] commonly seen in children: | *Symptoms of [[intussusception]], particularly recurrent or atypical [[intussusception]] commonly seen in children: | ||
* Pain:- A toddler or infant presenting with crampy abdominal pain with or without rectal bleeding | |||
* Inconsolable crying | |||
* Drawing up of the legs toward the abdomen<ref name="pmid22929138">{{cite journal |vauthors=Mandeville K, Chien M, Willyerd FA, Mandell G, Hostetler MA, Bulloch B |title=Intussusception: clinical presentations and imaging characteristics |journal=Pediatr Emerg Care |volume=28 |issue=9 |pages=842–4 |year=2012 |pmid=22929138 |doi=10.1097/PEC.0b013e318267a75e |url=}}</ref>. | |||
* Episode occur with 15-20 min intervals | |||
* Vomiting usually occurs after the first episode. Initially the vomiting is non-bilious but may convert to bilious as the obstruction progresses. | |||
* An abdominal mass (sausage shaped), may be palpated in the right side of abdomen. | |||
* Bloody stool or even occult blood<ref name="pmid1985640">{{cite journal |vauthors=Losek JD, Fiete RL |title=Intussusception and the diagnostic value of testing stool for occult blood |journal=Am J Emerg Med |volume=9 |issue=1 |pages=1–3 |year=1991 |pmid=1985640 |doi= |url=}}</ref>. | |||
* Current jelly stools which are a mixture of mucous and blood. (This is seen in minority of patients and is a late finding). | |||
* There can be intermittent pain free intervals in between episodes of pain. This can be confused with an episode of gastroenteritis<ref name="pmid3660243">{{cite journal |vauthors=West KW, Stephens B, Vane DW, Grosfeld JL |title=Intussusception: current management in infants and children |journal=Surgery |volume=102 |issue=4 |pages=704–10 |year=1987 |pmid=3660243 |doi= |url=}}</ref> | |||
The classic triad of pain, sausage-shaped abdominal mass and currant jelly stool are only seen in 15% of initial patient presentation<ref name="pmid3660243">{{cite journal |vauthors=West KW, Stephens B, Vane DW, Grosfeld JL |title=Intussusception: current management in infants and children |journal=Surgery |volume=102 |issue=4 |pages=704–10 |year=1987 |pmid=3660243 |doi= |url=}}</ref><ref name="pmid9148991">{{cite journal |vauthors=Yamamoto LG, Morita SY, Boychuk RB, Inaba AS, Rosen LM, Yee LL, Young LL |title=Stool appearance in intussusception: assessing the value of the term "currant jelly" |journal=Am J Emerg Med |volume=15 |issue=3 |pages=293–8 |year=1997 |pmid=9148991 |doi= |url=}}</ref> | |||
*Symptoms of [[bowel obstruction]], more common in adults: | *Symptoms of [[bowel obstruction]], more common in adults: | ||
*Symptoms of [[diverticular]] inflammation (ie, Meckel's [[diverticulitis]]): | *Symptoms of [[diverticular]] inflammation (ie, Meckel's [[diverticulitis]]): | ||
Revision as of 15:33, 2 January 2018
|
Meckel's diverticulum Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Meckel's diverticulum history and symptoms On the Web |
|
American Roentgen Ray Society Images of Meckel's diverticulum history and symptoms |
|
Risk calculators and risk factors for Meckel's diverticulum history and symptoms |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sudarshana Datta, MD [2]
Overview
Approximately 98% of people afflicted with Meckel's diverticulum are asymptomatic. If symptoms do occur, they typically appear before the age of two.
The majority of patients with [disease name] are asymptomatic.
OR
The hallmark of [disease name] is [finding]. A positive history of [finding 1] and [finding 2] is suggestive of [disease name]. The most common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3]. Common symptoms of [disease] include [symptom 1], [symptom 2], and [symptom 3]. Less common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3].
History and Symptoms
The most common presenting symptom is painless rectal bleeding, followed by intestinal obstruction, volvulus and intussusception. Occasionally, Meckel's diverticulitis may present with all the features of acute appendicitis. Also, severe pain in the upper abdomen is experienced by the patient along with bloating of the stomach region. At times, the symptoms are so painful such that they may cause sleepless nights with extreme pain in the abdominal area.
History and Symptoms
- The majority of patients with [disease name] are asymptomatic.
OR
- The hallmark of [disease name] is [finding]. A positive history of [finding 1] and [finding 2] is suggestive of [disease name]. The most common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3].
- Symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3].
History
Patients with [disease name]] may have a positive history of:
- [History finding 1]
- [History finding 2]
- [History finding 3]
Common Symptoms
- Meckel's diverticulum is usually asymptomatic and is found incidentally on abdominal imaging or surgical exploration performed for a presumptive diagnosis such as acute cholecystitis (exploratory laparotomy, laproscopy).
- The age of presentation for approximately half of all patients is less than 10 years of age.
Common symptoms of Meckel's diverticulum include:
- Lower gastrointestinal bleeding:
- Mechanism: presence of ectopic gastric mucosa leads to acid secretion within the diverticulum and ulceration of the small bowel
- Site: Downstream or adjacent to the diverticulum and not within it
- May be acute or chronic and insidious
- May be a massive bleed
- Usually painless
- More common in children
- In children: presents as maroon or dark red stools
- In adults: presents as melena as transit time through the colon is increased
- Acute abdominal complaints such as pain in the abdomen may be seen in complicated cases, mimicking the presentation of acute appendicitis
Less Common Symptoms
Less common symptoms of Meckel's diverticulum arise in complicated cases:
- Symptoms of intussusception, particularly recurrent or atypical intussusception commonly seen in children:
- Pain:- A toddler or infant presenting with crampy abdominal pain with or without rectal bleeding
- Inconsolable crying
- Drawing up of the legs toward the abdomen[1].
- Episode occur with 15-20 min intervals
- Vomiting usually occurs after the first episode. Initially the vomiting is non-bilious but may convert to bilious as the obstruction progresses.
- An abdominal mass (sausage shaped), may be palpated in the right side of abdomen.
- Bloody stool or even occult blood[2].
- Current jelly stools which are a mixture of mucous and blood. (This is seen in minority of patients and is a late finding).
- There can be intermittent pain free intervals in between episodes of pain. This can be confused with an episode of gastroenteritis[3]
The classic triad of pain, sausage-shaped abdominal mass and currant jelly stool are only seen in 15% of initial patient presentation[3][4]
- Symptoms of bowel obstruction, more common in adults:
- Symptoms of diverticular inflammation (ie, Meckel's diverticulitis):
- Symptoms of perforation:
References
- ↑ Mandeville K, Chien M, Willyerd FA, Mandell G, Hostetler MA, Bulloch B (2012). "Intussusception: clinical presentations and imaging characteristics". Pediatr Emerg Care. 28 (9): 842–4. doi:10.1097/PEC.0b013e318267a75e. PMID 22929138.
- ↑ Losek JD, Fiete RL (1991). "Intussusception and the diagnostic value of testing stool for occult blood". Am J Emerg Med. 9 (1): 1–3. PMID 1985640.
- ↑ 3.0 3.1 West KW, Stephens B, Vane DW, Grosfeld JL (1987). "Intussusception: current management in infants and children". Surgery. 102 (4): 704–10. PMID 3660243.
- ↑ Yamamoto LG, Morita SY, Boychuk RB, Inaba AS, Rosen LM, Yee LL, Young LL (1997). "Stool appearance in intussusception: assessing the value of the term "currant jelly"". Am J Emerg Med. 15 (3): 293–8. PMID 9148991.