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MECKEL'S DIVERTICULUM: Review of the Literature and Report of an Unusual Case

MECKEL'S DIVERTICULUM: Review of the Literature and Report of an Unusual Case Abstract MECKEL'S diverticulum, although not a common anomaly, has occupied a prominent place in the medical literature during the past half century, mainly because of the fact that it has a remarkable facility for producing complex and unusual clinical symptoms which defy accurate diagnosis. The embryologic, pathologic and clinical aspects of this anomaly have been established and capably presented and reviewed by many authors. It is not our intent to present a detailed discussion of what is well established but only to summarize the important facts and to present an unusual case. HISTORICAL BACKGROUND To Johann Fredric Meckel, a German anatomist and surgeon, is credited the first adequate description of the origin and clinical significance of the diverticulum bearing his name today, which appeared in a series of three papers published between 1808 and 1815. However, earlier reports of ileal diverticula appeared in the literature by Hildanus in 1598 and by References 1. Albrecht, E.: Ein Fall von Pancreasbildung in einem Meckel'schen Divertikel . München. med. Wchnschr. 48:2061, 1901. 2. Benson, R. E.; Dixon, C. F., and Waugh, J. M.: Nonmeckelian Diverticula of the Jejunum and Ileum , Ann. Surg. 118:377, 1943.Crossref 3. Bockus, H. L.: Gastroenterology , Philadelphia, W. B. Saunders Company, 1944. vol. 2. 4. Branch, C. D., and Gross, R. E.: Aberrant Pancreatic Tissue in Gastrointestinal Tract; Report of 24 Cases , Arch. Surg. 31:200 ( (Aug.) ) 1935.Crossref 5. Callander, C. L.: Surgical Anatomy , ed. 2, Philadelphia, W. B. Saunders Company, 1939. 6. Carlson, L. A.: An Anatomic and Pathologic Study of Meckel's Diverticula with Particular Reference to Frequency and Types of Heterotopias, Thesis, University of Minnesota Graduate School, 1937, p. 52. 7. Christie, A.: Meckel's Diverticulum: A Pathologic Study of 63 Cases , Am. J. Dis. Child. 42:544 ( (Sept.) ) 1931.Crossref 8. Conrad, H. A.: Meckel's Diverticulum , Am. J. Surg. 3:267, 1941.Crossref 9. Curd, H. H.: A Histologic Study of Meckel's Diverticulum, with Special Reference to Heterotopic Tissues , Arch. Surg. 32:506 ( (March) ) 1936.Crossref 10. Dragstedt, L. R.: Ulcus Acidum of Meckel's Diverticulum , J. A. M. A. 101:20 ( (July 1) ) 1933.Crossref 11. Farr, C. E., and Penke, M.: Meckel's Diverticulum , Ann. Surg. 101:1026, 1935.Crossref 12. Gendel, S., and Beaver, M. G.: An Unusual Case of Meckel's Diverticulum , Ann. Surg. 121:891, 1945.Crossref 13. Greenblatt, R. B.; Pund, E. R., and Chaney, R. H.: Meckel's Diverticulum , Am. J. Surg. 31:288, 1936.Crossref 14. Hallendorf, L. C., and Lovelace, W. R., II: Aberrant Gastric Mucosa and Pancreatic Tissue in Bleeding Meckel's Diverticulum: Report of Case , Proc. Staff. Meet., Mayo Clin. 22:531947. 15. Halstead, A. E.: Intestinal Obstruction from Meckel's Diverticulum , Ann. Surg. 35:471, 1902. 16. Harbin, R. M.: Meckel's Diverticulum , Surg., Gynec. & Obst. 51:863, 1930. 17. Harkins, H. N.: Intussusception Due to Invaginated Meckel's Diverticulum , Ann. Surg. 98:1070, 1933. 18. Harrington, S. W.: Strangulated Meckel's Diverticulum in Right Femoral Hernia , S. Clin. North America 6:1180, 1926. 19. Hertzog, A. J.. and Carlson, L. A.: Carcinoid of Meckel's Diverticulum: Report of 2 Cases , Arch. Path. 20:587, ( (Oct.) ) 1935. 20. Horgan, E. J.: Accessory Pancreatic Tissue: Report of 2 Cases , Arch. Surg. 2:521 ( (May) ) 1921. 21. Horn, R. C., and Rhoads, J. E.: Regional Enteritis Involving Meckel's Diverticulum: Perforation of the Diverticulum and Fistula Formation , Ann. Surg. 119:274, 1944. 22. Hunt, V. C., and Bonesteel, H. T. S.: Meckel's Diverticulum Containing Aberrant Pancreas , Arch. Surg. 28:425 ( (March) ) 1934. 23. Johnston, L. B., and Renner, G., Jr.: Peptic Ulcer of Meckel's Diverticulum , Surg., Gynec. & Obst. 49:198, 1934. 24. Kittle, F. C.; Jenkins, H. P., and Dragstedt, L. R.: Patent Omphalomesenteric Duct and Its Relation to the Diverticulum of Meckel , Arch. Surg. 54:10 ( (Jan.) ) 1947.Crossref 25. Ladd, W. E., and Gross, R. E.: Abdominal Surgery of Infancy and Childhood , Philadelphia, W. B. Saunders Company, 1941. 26. Lichtenstein, M. E.: Meckel's Diverticulum: Intestinal Obstruction Due to Invagination and Intussusception; Peritonitis Due to Perforation by Fish Bone , Quart. Bull., Northwestern Univ. M. School 15:296, 1941. 27. Maddock, W. G., and Coventry, M. B.: A Perforated Ulcer of the Ileum Opposite a Meckel's Diverticulum , Surg., Gynec. & Obst. 73:105, 1941. 28. Maguire, C. H.: Meckel's Diverticulum as an Acute Surgical Emergency , Arch. Surg. 56:65 ( (Jan.) ) 1948. 29. Matt, J. G., and Timpone, P. J.: Peptic Ulcer of Meckel's Diverticulum , Am. J. Surg. 47:612, 1940. 30. McRoberts, J. W.: Meckel's Diverticulum , Arch. Surg. 56:718 ( (June) ) 1948. 31. Meckel, J. F.: Handbuch der pathologischen Anatomie , Leipzig, C. H. Reclam, 1812, vol. 1, p. 553. 32. Ueber die Divertikel am Darmkanal , Arch. f. d. Physiol. 9:421, 1809. 33. Meckel's Diverticulum, Cabot Case 22101 , New England J. Med. 214:481, 1936. 34. Migliaccio, A. V., and Begg, C.: Meckel's Diverticulum , Am. J. Surg. 76:188, 1948. 35. Morlock, C. G., and Bennett, J. G.: An Unusual Complication of a Meckelian Diverticulum , Ann. Surg. 128:153, 1948. 36. Mulsow, F. S.: Meckel's Diverticulum Containing Calculi , Am. J. Digest. Dis. 10:188, 1943. 37. Noel, W. M.: Meckel's Diverticulum , Am. J. Surg. 49:454, 1940. 38. Nygaard, K. K., and Walters, W.: Malignant Tumors of Meckel's Diverticulum: Report of Case of Leiomyosarcoma , Arch. Surg. 35:1159 ( (Dec.) ) 1937. 39. Pemberton, J. de J., and Stalker, L. K.: Meckel's Diverticulum , Surgery 3:563, 1938. 40. Penberthy, G. C., and Benson, C. D.: The Complications of Meckel's Diverticulum in Infants and Children , S. Clin. North America 28:1221, 1948. 41. Pfahler, G. E.: The Roentgenological Diagnosis of Meckel's Diverticulum , Surg., Gynec. & Obst. 109:929, 1934. 42. Schullinger, R. N., and Stout, A. P.: Meckel's Diverticulum: Report of Case of Hemorrhage in Bowel Associated with Meckel's Diverticulum That Presented Adenoma Composed of Gastric and Duodenal Glands , Arch. Surg. 28:440 ( (March) ) 1934. 43. Shaetz, E. G.: Beiträge zur Morphologie des Meckelschen Divertikels , Beitr. z. path. Anat. u. z. allg. Path. 74:115, 1925. 44. Sibley, W. L.: Meckel's Diverticulum: Dyspepsia Meckeli from Heterotopic Gastric Mucosa , Arch. Surg. 49:156 ( (Sept.) ) 1944. 45. Thompson, J. E.: Perforated Peptic Ulcer In Meckel's Diverticulum , Ann. Surg. 105:44, 1937. 46. Troll, M. M.: Aberrant Pancreatic and Gastric Tissue in the Intestinal Tract , Arch. Path. 38:375 ( (Dec.) ) 1944. 47. Waugh, J. M.; Herrell, W. D., and Crumpacker, L. K.: Peptic Ulcer in Meckel's Diverticulum Causing Intrinsic Intestinal Obstruction , Surgery 11:385, 1942. 48. Weir, J. M.: Carcinoma of Meckel's Diverticulum: Report of a Case , Arch. Path. 24:791 ( (Dec.) ) 1937. 49. Wellington, J. R.: Meckel's Diverticulum , Surg., Gynec. & Obst. 16:74, 1913. 50. Womack, N. A., and Seigert, R. B.: Surgical Aspects of Lesions of Meckel's Diverticulum , Ann. Surg. 108:221, 1938. 51. Zeidman, H. M.: Meckel's Diverticulum , Am. J. Surg. 76:69, 1948. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives Surgery American Medical Association

MECKEL'S DIVERTICULUM: Review of the Literature and Report of an Unusual Case

MERRITT, W. H.; RABE, M. A.
A.M.A. Archives Surgery , Volume 61 (6) – Dec 1, 1950
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References (47)

Publisher
American Medical Association
Copyright
Copyright © 1950 American Medical Association. All Rights Reserved.
ISSN
0096-6908
DOI
10.1001/archsurg.1950.01250021093010
Publisher site
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Abstract

Abstract MECKEL'S diverticulum, although not a common anomaly, has occupied a prominent place in the medical literature during the past half century, mainly because of the fact that it has a remarkable facility for producing complex and unusual clinical symptoms which defy accurate diagnosis. The embryologic, pathologic and clinical aspects of this anomaly have been established and capably presented and reviewed by many authors. It is not our intent to present a detailed discussion of what is well established but only to summarize the important facts and to present an unusual case. HISTORICAL BACKGROUND To Johann Fredric Meckel, a German anatomist and surgeon, is credited the first adequate description of the origin and clinical significance of the diverticulum bearing his name today, which appeared in a series of three papers published between 1808 and 1815. However, earlier reports of ileal diverticula appeared in the literature by Hildanus in 1598 and by References 1. Albrecht, E.: Ein Fall von Pancreasbildung in einem Meckel'schen Divertikel . München. med. Wchnschr. 48:2061, 1901. 2. Benson, R. E.; Dixon, C. F., and Waugh, J. M.: Nonmeckelian Diverticula of the Jejunum and Ileum , Ann. Surg. 118:377, 1943.Crossref 3. Bockus, H. L.: Gastroenterology , Philadelphia, W. B. Saunders Company, 1944. vol. 2. 4. Branch, C. D., and Gross, R. E.: Aberrant Pancreatic Tissue in Gastrointestinal Tract; Report of 24 Cases , Arch. Surg. 31:200 ( (Aug.) ) 1935.Crossref 5. Callander, C. L.: Surgical Anatomy , ed. 2, Philadelphia, W. B. Saunders Company, 1939. 6. Carlson, L. A.: An Anatomic and Pathologic Study of Meckel's Diverticula with Particular Reference to Frequency and Types of Heterotopias, Thesis, University of Minnesota Graduate School, 1937, p. 52. 7. Christie, A.: Meckel's Diverticulum: A Pathologic Study of 63 Cases , Am. J. Dis. Child. 42:544 ( (Sept.) ) 1931.Crossref 8. Conrad, H. A.: Meckel's Diverticulum , Am. J. Surg. 3:267, 1941.Crossref 9. Curd, H. H.: A Histologic Study of Meckel's Diverticulum, with Special Reference to Heterotopic Tissues , Arch. Surg. 32:506 ( (March) ) 1936.Crossref 10. Dragstedt, L. R.: Ulcus Acidum of Meckel's Diverticulum , J. A. M. A. 101:20 ( (July 1) ) 1933.Crossref 11. Farr, C. E., and Penke, M.: Meckel's Diverticulum , Ann. Surg. 101:1026, 1935.Crossref 12. Gendel, S., and Beaver, M. G.: An Unusual Case of Meckel's Diverticulum , Ann. Surg. 121:891, 1945.Crossref 13. Greenblatt, R. B.; Pund, E. R., and Chaney, R. H.: Meckel's Diverticulum , Am. J. Surg. 31:288, 1936.Crossref 14. Hallendorf, L. C., and Lovelace, W. R., II: Aberrant Gastric Mucosa and Pancreatic Tissue in Bleeding Meckel's Diverticulum: Report of Case , Proc. Staff. Meet., Mayo Clin. 22:531947. 15. Halstead, A. E.: Intestinal Obstruction from Meckel's Diverticulum , Ann. Surg. 35:471, 1902. 16. Harbin, R. M.: Meckel's Diverticulum , Surg., Gynec. & Obst. 51:863, 1930. 17. Harkins, H. N.: Intussusception Due to Invaginated Meckel's Diverticulum , Ann. Surg. 98:1070, 1933. 18. Harrington, S. W.: Strangulated Meckel's Diverticulum in Right Femoral Hernia , S. Clin. North America 6:1180, 1926. 19. Hertzog, A. J.. and Carlson, L. A.: Carcinoid of Meckel's Diverticulum: Report of 2 Cases , Arch. Path. 20:587, ( (Oct.) ) 1935. 20. Horgan, E. J.: Accessory Pancreatic Tissue: Report of 2 Cases , Arch. Surg. 2:521 ( (May) ) 1921. 21. Horn, R. C., and Rhoads, J. E.: Regional Enteritis Involving Meckel's Diverticulum: Perforation of the Diverticulum and Fistula Formation , Ann. Surg. 119:274, 1944. 22. Hunt, V. C., and Bonesteel, H. T. S.: Meckel's Diverticulum Containing Aberrant Pancreas , Arch. Surg. 28:425 ( (March) ) 1934. 23. Johnston, L. B., and Renner, G., Jr.: Peptic Ulcer of Meckel's Diverticulum , Surg., Gynec. & Obst. 49:198, 1934. 24. Kittle, F. C.; Jenkins, H. P., and Dragstedt, L. R.: Patent Omphalomesenteric Duct and Its Relation to the Diverticulum of Meckel , Arch. Surg. 54:10 ( (Jan.) ) 1947.Crossref 25. Ladd, W. E., and Gross, R. E.: Abdominal Surgery of Infancy and Childhood , Philadelphia, W. B. Saunders Company, 1941. 26. Lichtenstein, M. E.: Meckel's Diverticulum: Intestinal Obstruction Due to Invagination and Intussusception; Peritonitis Due to Perforation by Fish Bone , Quart. Bull., Northwestern Univ. M. School 15:296, 1941. 27. Maddock, W. G., and Coventry, M. B.: A Perforated Ulcer of the Ileum Opposite a Meckel's Diverticulum , Surg., Gynec. & Obst. 73:105, 1941. 28. Maguire, C. H.: Meckel's Diverticulum as an Acute Surgical Emergency , Arch. Surg. 56:65 ( (Jan.) ) 1948. 29. Matt, J. G., and Timpone, P. J.: Peptic Ulcer of Meckel's Diverticulum , Am. J. Surg. 47:612, 1940. 30. McRoberts, J. W.: Meckel's Diverticulum , Arch. Surg. 56:718 ( (June) ) 1948. 31. Meckel, J. F.: Handbuch der pathologischen Anatomie , Leipzig, C. H. Reclam, 1812, vol. 1, p. 553. 32. Ueber die Divertikel am Darmkanal , Arch. f. d. Physiol. 9:421, 1809. 33. Meckel's Diverticulum, Cabot Case 22101 , New England J. Med. 214:481, 1936. 34. Migliaccio, A. V., and Begg, C.: Meckel's Diverticulum , Am. J. Surg. 76:188, 1948. 35. Morlock, C. G., and Bennett, J. G.: An Unusual Complication of a Meckelian Diverticulum , Ann. Surg. 128:153, 1948. 36. Mulsow, F. S.: Meckel's Diverticulum Containing Calculi , Am. J. Digest. Dis. 10:188, 1943. 37. Noel, W. M.: Meckel's Diverticulum , Am. J. Surg. 49:454, 1940. 38. Nygaard, K. K., and Walters, W.: Malignant Tumors of Meckel's Diverticulum: Report of Case of Leiomyosarcoma , Arch. Surg. 35:1159 ( (Dec.) ) 1937. 39. Pemberton, J. de J., and Stalker, L. K.: Meckel's Diverticulum , Surgery 3:563, 1938. 40. Penberthy, G. C., and Benson, C. D.: The Complications of Meckel's Diverticulum in Infants and Children , S. Clin. North America 28:1221, 1948. 41. Pfahler, G. E.: The Roentgenological Diagnosis of Meckel's Diverticulum , Surg., Gynec. & Obst. 109:929, 1934. 42. Schullinger, R. N., and Stout, A. P.: Meckel's Diverticulum: Report of Case of Hemorrhage in Bowel Associated with Meckel's Diverticulum That Presented Adenoma Composed of Gastric and Duodenal Glands , Arch. Surg. 28:440 ( (March) ) 1934. 43. Shaetz, E. G.: Beiträge zur Morphologie des Meckelschen Divertikels , Beitr. z. path. Anat. u. z. allg. Path. 74:115, 1925. 44. Sibley, W. L.: Meckel's Diverticulum: Dyspepsia Meckeli from Heterotopic Gastric Mucosa , Arch. Surg. 49:156 ( (Sept.) ) 1944. 45. Thompson, J. E.: Perforated Peptic Ulcer In Meckel's Diverticulum , Ann. Surg. 105:44, 1937. 46. Troll, M. M.: Aberrant Pancreatic and Gastric Tissue in the Intestinal Tract , Arch. Path. 38:375 ( (Dec.) ) 1944. 47. Waugh, J. M.; Herrell, W. D., and Crumpacker, L. K.: Peptic Ulcer in Meckel's Diverticulum Causing Intrinsic Intestinal Obstruction , Surgery 11:385, 1942. 48. Weir, J. M.: Carcinoma of Meckel's Diverticulum: Report of a Case , Arch. Path. 24:791 ( (Dec.) ) 1937. 49. Wellington, J. R.: Meckel's Diverticulum , Surg., Gynec. & Obst. 16:74, 1913. 50. Womack, N. A., and Seigert, R. B.: Surgical Aspects of Lesions of Meckel's Diverticulum , Ann. Surg. 108:221, 1938. 51. Zeidman, H. M.: Meckel's Diverticulum , Am. J. Surg. 76:69, 1948.

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A.M.A. Archives Surgery – American Medical Association

Published: Dec 1, 1950

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