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Medicina (Buenos Aires)

versión impresa ISSN 0025-7680versión On-line ISSN 1669-9106

Medicina (B. Aires) vol.83 no.2 Ciudad Autónoma de Buenos Aires jun. 2023

 

IMÁGENES EN MEDICINA

Intestinal intussusception caused by a Meckel´s diverticulum

Bruna Suda Rodrigues1 

Deborah D. Coelho Marra2 

Márcio L. Duarte2  * 

Carolina de Campos Silva1 

Luciane Bastos Fernandes de Oliveira1 

Élcio R. Duarte1  2 

1 Irmandade da Santa Casa de Misericórdia de Santos, Santos, São Paulo, Brazil

2 Faculdade de Ciências Médicas de Santos, Santos, São Paulo, Brazil

A 6-year-old girl complaining of abdominal pain and vomiting for one day. She had already reported similar pain in the previous two months, which solved after enema’s administration. The physical examination did not show pain, palpable masses or signs of peritoneal irritation. An ultrasonography demonstrated two hy poechoic and heterogeneous nodular images, characteri zed as a target lesion (Fig. 1, white arrows), which were interconnected by intestinal loops with maintained pe ristalsis (Fig. 1, black arrow). A laparotomy surgery was performed, in which the site of intussusception was evi denced, without ischemia from intestinal loops. A manual reduction of the ileo-ileal invagination detected that the telescoping (intussusceptum) was a Meckel’s diverti culum (Fig. 2). An enterectomy with end-to-end anasto mosis was performed. The patient was discharged a week later from the hospital and has been under outpatient follow-up since then.

Figura 1 

Figura 2 

Usually Meckel’s diverticulum remains without symp toms, but 4-16% of individuals will become symptomatic, most commonly showing with bleeding, obstruction, di verticulitis, or perforation. These complications are seen more frequently in neonates and young children when compared to adults. In general, the symptomatic Meckel’s diverticulum’s gold standard treatment is laparoscopic or open resection. Complications can occur after resection, which wound’s infection are the most common complica tion.

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