Diagnostics of chronic small intestinal obstruction in patient with ectopic pancreas in the Meckel's diverticulum (case report)

Aim of the case report presentation. To draw attention of general practitioners to the rare case of intestinal obstruction - intussusception of Meckel's diverticulum in small intestinal lumen. Key points. The present case is characterized by development of chronic small-intestinal obstruction d...

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Main Authors: Zinaida A. Lemeshko, O. S. Shifrin, A. V. Korolev, T. L. Lemina, I. A. Sokolina, A. Ye. Leonovich, K. A. Lesko, A. S. Tertychny, V. T. Ivashkin
Format: Article
Language:Russian
Published: Gastro LLC 2016-08-01
Series:Российский журнал гастроэнтерологии, гепатологии, колопроктологии
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Online Access:https://www.gastro-j.ru/jour/article/view/38
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author Zinaida A. Lemeshko
O. S. Shifrin
A. V. Korolev
T. L. Lemina
I. A. Sokolina
A. Ye. Leonovich
K. A. Lesko
A. S. Tertychny
V. T. Ivashkin
author_facet Zinaida A. Lemeshko
O. S. Shifrin
A. V. Korolev
T. L. Lemina
I. A. Sokolina
A. Ye. Leonovich
K. A. Lesko
A. S. Tertychny
V. T. Ivashkin
author_sort Zinaida A. Lemeshko
collection DOAJ
description Aim of the case report presentation. To draw attention of general practitioners to the rare case of intestinal obstruction - intussusception of Meckel's diverticulum in small intestinal lumen. Key points. The present case is characterized by development of chronic small-intestinal obstruction due to repeating intussusception of Meckel's diverticulum in the small intestinal lumen. Episodes of intussusception manifested clinically by attacks of severe right iliac pain that made patient to take «embryonic posture». Deep palpation revealed «spastic bowel» sign in the area of intussusception. A specific type of intussusception was detected by transabdominal ultrasound: thickening and «lamination of intestinal wall» due to «diverticulum interposition» into the lumen of ileum and «overlaying» of wall layers. The evacuation delay at the small intestine was followed by dilation of overlying loops of the small intestine containing bulky liquid content; pendular movement of liquid observed at ultrasonography with visible «air-fluid levels» at plain radiograph. The patient at the same time had frequent liquid stool that indicated presence of incomplete obstruction. Surgical intervention for intussusception and resection of diverticulum-containing portion of the small intestine resulted in improvement of the patient state, relief of pain attacks and signs of intestinal obstruction. Histological examination of resected specimen revealed the presence of ectopic pancreatic tissue in the Meckel's diverticulum wall. Conclusion. Carrying out differential diagnosis in colicky abdominal pain should encompass existence of Meckel's diverticulum with recurrent small intestinal intussusception that can result in chronic intestinal obstruction. In diverticulum wall ectopic pancreas can be detected. Key words: ileus, Meckel's diverticulum, ectopic pancreas.
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series Российский журнал гастроэнтерологии, гепатологии, колопроктологии
spelling doaj-art-28e22250e6ef49e3b46c80bdce7c65142025-02-10T16:14:34ZrusGastro LLCРоссийский журнал гастроэнтерологии, гепатологии, колопроктологии1382-43762658-66732016-08-01262929810.22416/1382-4376-2016-26-2-92-9838Diagnostics of chronic small intestinal obstruction in patient with ectopic pancreas in the Meckel's diverticulum (case report)Zinaida A. Lemeshko0O. S. Shifrin1A. V. Korolev2T. L. Lemina3I. A. Sokolina4A. Ye. Leonovich5K. A. Lesko6A. S. Tertychny7V. T. Ivashkin8State educational government-financed institution of higher professional education «Sechenov First Moscow state medical university»State educational government-financed institution of higher professional education «Sechenov First Moscow state medical university»State educational government-financed institution of higher professional education «Sechenov First Moscow state medical university»State educational government-financed institution of higher professional education «Sechenov First Moscow state medical university»State educational government-financed institution of higher professional education «Sechenov First Moscow state medical university»State educational government-financed institution of higher professional education «Sechenov First Moscow state medical university»State educational government-financed institution of higher professional education «Sechenov First Moscow state medical university»State educational government-financed institution of higher professional education «Sechenov First Moscow state medical university»State educational government-financed institution of higher professional education «Sechenov First Moscow state medical university»Aim of the case report presentation. To draw attention of general practitioners to the rare case of intestinal obstruction - intussusception of Meckel's diverticulum in small intestinal lumen. Key points. The present case is characterized by development of chronic small-intestinal obstruction due to repeating intussusception of Meckel's diverticulum in the small intestinal lumen. Episodes of intussusception manifested clinically by attacks of severe right iliac pain that made patient to take «embryonic posture». Deep palpation revealed «spastic bowel» sign in the area of intussusception. A specific type of intussusception was detected by transabdominal ultrasound: thickening and «lamination of intestinal wall» due to «diverticulum interposition» into the lumen of ileum and «overlaying» of wall layers. The evacuation delay at the small intestine was followed by dilation of overlying loops of the small intestine containing bulky liquid content; pendular movement of liquid observed at ultrasonography with visible «air-fluid levels» at plain radiograph. The patient at the same time had frequent liquid stool that indicated presence of incomplete obstruction. Surgical intervention for intussusception and resection of diverticulum-containing portion of the small intestine resulted in improvement of the patient state, relief of pain attacks and signs of intestinal obstruction. Histological examination of resected specimen revealed the presence of ectopic pancreatic tissue in the Meckel's diverticulum wall. Conclusion. Carrying out differential diagnosis in colicky abdominal pain should encompass existence of Meckel's diverticulum with recurrent small intestinal intussusception that can result in chronic intestinal obstruction. In diverticulum wall ectopic pancreas can be detected. Key words: ileus, Meckel's diverticulum, ectopic pancreas.https://www.gastro-j.ru/jour/article/view/38кишечная непроходимостьдивертикул меккеляэктопия поджелудочной железы
spellingShingle Zinaida A. Lemeshko
O. S. Shifrin
A. V. Korolev
T. L. Lemina
I. A. Sokolina
A. Ye. Leonovich
K. A. Lesko
A. S. Tertychny
V. T. Ivashkin
Diagnostics of chronic small intestinal obstruction in patient with ectopic pancreas in the Meckel's diverticulum (case report)
Российский журнал гастроэнтерологии, гепатологии, колопроктологии
кишечная непроходимость
дивертикул меккеля
эктопия поджелудочной железы
title Diagnostics of chronic small intestinal obstruction in patient with ectopic pancreas in the Meckel's diverticulum (case report)
title_full Diagnostics of chronic small intestinal obstruction in patient with ectopic pancreas in the Meckel's diverticulum (case report)
title_fullStr Diagnostics of chronic small intestinal obstruction in patient with ectopic pancreas in the Meckel's diverticulum (case report)
title_full_unstemmed Diagnostics of chronic small intestinal obstruction in patient with ectopic pancreas in the Meckel's diverticulum (case report)
title_short Diagnostics of chronic small intestinal obstruction in patient with ectopic pancreas in the Meckel's diverticulum (case report)
title_sort diagnostics of chronic small intestinal obstruction in patient with ectopic pancreas in the meckel s diverticulum case report
topic кишечная непроходимость
дивертикул меккеля
эктопия поджелудочной железы
url https://www.gastro-j.ru/jour/article/view/38
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