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Images in Medicine

Year :2013 Month : March-April Volume : 2 Issue : 1 Page : 35 - 36 Full Version

Dual Pathology


Prathvi Shetty, Leo Francis Tauro
1. Assistant Professor 2. Professor, Father Muller Medical Collage and Hospital, Kankanady, Mangalore, Karnataka, India.
 
Correspondence Address :
Dr. Prathvi Shetty
Department of General Surgery, Father Muller Medical
Collage and Hospital, kankanady, Mangalore -575002,
India.
Email: prathviz@gmail.com
 
ABSTRACT

:
Keywords :
DOI and Others : Financial OR OTHER COMPETING INTERESTS:
None.

Date of Submission: Apr 24, 2012
Date of Peer Review: Oct 30, 2012
Date of Acceptance: Oct 31, 2012
Date of Publishing: Apr 01, 2013
 
INTRODUCTION

A 18 years old girl presented with complain of right iliac fossa pain of three day duration, nauseating feeling and two episode of vomiting. On physical examination, she had tenderness in right iliac fossa medial to Mcburney’s point. Her haemogram revealed elevated total count and neutrophilia. Ultrasound showed mildly inflamed appendix. Appendectomy was done with Lanz incision and intra peritoneal another tubular structure of 6cms length was found around 30cms from Ileocecal junction in the anti mesenteric border of ileum (Table/Fig 1) and (Table/Fig 2).

Histopathology showed Meckel’s Diverticulum(MD) with ectopic gastric mucosa and appendix with trans mural inflammation.

MD is one of the most commonest anomaly of gastrointestinal tract. It is due to persistent ompalomesentric (vitelline duct), usually seen in 2% of the population mostly in males. In infants they present as painless bleeding or infrequently present as intussusception or volvulus (1).

In adults most commonly seen in males, they can mimic features of appendicitis as seen in our case. Ideal investigation of choice would be Technetium 99 scintigraphy . Computerised tomography scan and colonoscopy evaluation is helpful but there should be high index of suspicion (2). Wedge excision or segmental resection of ileum is the treatment although later is recommended as usually there is ectopic gastric or pancreatic tissue (3).
 
REFERENCES
1.
Malik AA. Wani KA, Khaja AR. Meckel’s diverticulum-revisited. Saudi J Gastroenterol. 2010;16:3–7.
2.
Connolly SA, Drubach LA, Connolly LP. Meckel’s diverticulitis: diagnosis with computed tomography and Tc-99m pertechnetate scintigraphy.Clin Nucl Med. Dec 2004;29:823-24.
3.
Tauro LF,Martis JJ, Menezes LT,Shenoy HD. Clinical profile and surgical outcome of Mekel”s Diverticulum.J Indian Med Assoc. 2011Jul;109:489-90.  [Google Scholar]
 
TABLES AND FIGURES
[Table/Fig-1] [Table/Fig-2]
 
 
 

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