Intussusception and bleeding of a Meckel’s diverticulum diagnosed by colonoscopy - 22/08/11
Doi : 10.1016/j.gie.2006.08.019
| Commentary A young person having no history of abdominal surgery who presents with a small bowel obstruction is likely to have either a hernia or a neoplasm of the small intestine; associated rectal bleeding or bloody diarrhea adds the diagnostic possibilities of intussusception and intestinal ischemia. Diseases do not read textbooks or journals, however, and Meckel’s diverticulum also may manifest with these symptoms. Small bowel obstruction caused by Meckel’s diverticula may result from invagination of the diverticulum and intussusception with the diverticulum as the lead point, herniation of bowel through a defect in the diverticular mesentery, volvulus through or obstruction from a fibrous remnant of the omphalomesenteric duct, an entrapped foreign body such as an enterolith or a stricture from superimposed peptic disease, or even superimposed Crohn’s disease. On physical examination think intussusception when there is an “empty” right lower quadrant and a distended upper abdomen, so-called Dance’s sign. Clearly, it is easier to make the diagnosis of intussusception on CT scan than at colonoscopy, but neither will yield a specific cause for the obstruction and for that we need the help of our colleagues, the surgeon and the pathologist. Lawrence J. Brandt, MD Associate Editor for Focal Points |
© 2007
American Society for Gastrointestinal Endoscopy. Publié par Elsevier Masson SAS. Tous droits réservés.
Vol 65 - N° 6
P. 920-921 - mai 2007 Retour au numéro
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