Q. Least common complication of Meckel's diverticulum is
a) Bleeding
b) Obstruction
c) Neoplasm
d) Obstruction
While many individuals remain asymptomatic, complications of Meckel's diverticulum can lead to significant clinical issues requiring medical intervention.
Answer is free
Ans ) c Neoplasm
The most common clinical presentation of Meckel’s diverticulum is gastrointestinal bleeding, which occurs in 25% to 50% of patients who present with complications.
Bleeding is often due to ulceration of the diverticulum. This bleeding can manifest as painless rectal bleeding
Another potential complication is intestinal obstruction, which can occur if the diverticulum becomes incarcerated or twisted. This situation may lead to bowel ischemia and perforation if not managed quickly.
Intestinal obstruction occur as a result of a volvulus of the small bowel around a diverticulum associated with a fibrotic band attached to the abdominal wall, intussusception, or, rarely, incarceration of the diverticulum in an inguinal hernia (Littre hernia)
Diverticulitis accounts for 10% to 20% of symptomatic presentations.
Neoplasms can also occur in a Meckel’s diverticulum, with NET as the most common malignant neoplasm (77%). Other histologic types include adenocarcinoma (11%), which generally originates from the gastric mucosa, and GIST (10%) and lymphoma (1%).
Complications of Meckel's diverticulum can be recognised and managed early if there is high index of suspicion
Q) Duplication of the intestine associated with A. Heterotopic mucosa B. Smooth muscle component C. Associated with spinal / vertebral defects D. All are correct
Q) Which of the following is an Adverse factor hindering spontaneous fistula closure:
a) Tract <1cm
b)Transferrin > 200
c) Location in esophagus
d) First surgery done in the same institution
a) Tract less than 1 cm
Spontaneous fistula closure
Short-turnover protein (prealbumin, retinol-binding protein, transferrin) levels should be measured at least weekly to assess the adequacy of protein delivery. An ongoing catabolic state will adversely affect short-turnover protein levels, even with maximal protein delivery.
Failure of an enterocutaneous fistula to close spontaneously is associated with acronym FRIENDS):
the presence of a foreign body within the tract or adjacent to it, previous radiation exposure of the site, ongoing inflammation (most commonly from Crohn disease) or infection that contributes to a catabolic state, epithelialization of the fistula tract (particularly if the fistula tract is less than 2 cm long), neoplasm, distal intestinal obstruction, and pharmacologic doses of steroids.
Fistulas associated with a concurrent pancreatic fistula also have a low rate of spontaneous closure, as do those occurring in the presence of malnutrition or adjacent infection.
In general, anatomic locations that are favorable for closure are the oropharynx, esophagus, duodenal stump, pancreas, biliary tree, and jejunum.