Case report| Volume 89, ISSUE 3, P696-699, March 1955

Intussusception due to invaginated Meckel's diverticulum after previous appendectomy

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      • 1.
        1. An eleven year old boy with a preoperative diagnosis of intestinal obstruction secondary to postoperative adhesions was operated upon and found to have a Meckel's diverticulum with intussusception. Reduction of the intussusception and excision of the diverticulum resulted in a cure. Appendectomy had been performed two years prior to this admission and pathologic diagnosis was chronic lymphoid appendix. Inadequate exploration of the terminal ileum resulted in a failure to discover the presence of a Meckel's diverticulum. Case report and a review of the literature is presented.
      • 2.
        2. In cases diagnosed as acute appendicitis, in which the appendiceal pathology is not concomitant with the severity of clinical symptoms, a thorough investigation of the ileum should be made prior to removing the appendix. It is not satisfactory to investigate the terminal 1 to 2 feet of ileum but rather the distal 3Math Eq to 4 feet should be explored.
      • 3.
        3. Meckel's intussusception occurs in older age groups as compared to the acute infantile intussusceptions. The average age is 13.1 years, with a preponderance in males (79 per cent).
      • 4.
        4. Clinically Meckel's diverticulum with intussusception runs a subacute course as compared to the acute picture presented in other intussusceptions.
      • 5.
        5. Conditions most frequently confused with Meckel's intussusception are: (1) appendicitis, (2) intussusception without Meckel's diverticulum and (3) other affections of Meckel's diverticulum.
      • 6.
        6. The choice of operation is reduction of the intussusception and excision of the diverticulum. If bowel resection is necessary, it is less dangerous because the patients are in older age groups as compared to the acute intussusceptions of infancy and early childhood.
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