[Acute hemorrhage from Meckel's diverticulum--Laparotomy or laparoscopy?].
Meckel's diverticulum is the most common congenital malformation of the gastrointestinal tract with a potential risk to develop complications such as obstruction, diverticulitis or intussusception. Lower gastrointestinal bleeding due to ulceration of heterotopic gastric tissue of the diverticulum is a known phenomenon in children and young adults. We present two cases of a 15-year-old girl and a 20-year-old man that revealed a massive lower gastrointestinal hemorrhage of unknown origin. In this emergency situation laparotomy was performed in combination with lower endoscopy as rendezvous manouver. In both cases a Meckel's diverticulum with peptic ulceration was the source of hemorrhage, in one case the bleeding was active and visible. After resection of a short small bowel segment and end-to-end anastomosis the postoperative course was uneventful. We prefer in the case of lower gastrointestinal hemorrhage with hemodynamic instability laparotomy with intraoperative endoscopy instead of laparoscopy.
Knoop
M
M
Klinik für Allgemein- und Viszeralchirurgie, Johanniter Krankenhaus der Altmark, Stendal, Akademisches Lehrkrankenhaus der Otto-von-Guericke Universität Magdeburg, Germany. Mdrknoop@aol.com
Vorwerk
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Friedrichs
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KS
D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical; D003113:Colonoscopy; D003937:Diagnosis, Differential; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008467:Meckel Diverticulum / Q000175:diagnosis / Q000601:surgery*