Two cases had direct complications (diverticulitis, diverticulitis with SB525334 molecular weight perforation) of Meckel’s diverticulum by roundworms, both cases were a male children. Nine patients had an incidental finding of grossly as well as histologically documented normal Meckel’s diverticulum. Three patients had gangrenous Meckel’s diverticulum; one had secondary to volvulus of ileum caused by presence of worm bolus at
proximal and distal end leading to gangrene of ileum and its located Meckel’s diverticulum (Fig. 1A, B &1C). Two had secondary to mechanical obstruction to gut by long proximal worm bolus leading to gangrene of distal ileum with its associated Meckel’s diverticulum. Figure 1 Demonstration of ileum with its located Meckel’s diverticulum, both had gangrene. Ileum had twist which lead to gangrene of ileum, together with its located Meckel’s diverticulum with worms seen inside. There was proximal and distal bolus of worms at point of twist around which ileum had volvulus. B. Demonstration of resected ends of ileum which had gangrene. Both resected ends were used as enterotomy sites for removal of worms.
C. Demonstration of worms removed via enterotomy wound. One patient had markedly inflamed Meckel’s diverticulum with single impacted roundworm present inside. Perforation selleck compound of Meckel’s diverticulum (Diverticulitis) with three roundworms present in peritoneal cavity was seen in one case (Fig 2). Two roundworms were Idoxuridine wrapped in ARRY-438162 omentum and one was lying freely in peritoneal cavity. Figure 2 Perforation at tip of Meckel’s diverticulum through which worms escape into peritoneal cavity. Diverticulectomy was done in 9 cases and the segmental resection
in 5 cases including resection anastomosis those who had gangrene of ileum. There was no presence of any ectopic tissue in specimens of Meckel’s diverticulum on histopathology. Three patients had post operative wound infection. All were treated with anthelmintics postoperatively. Discussion Meckel’s diverticulum is the most common congenital anomaly of the gastrointestinal tract [3]. The occurrence of symptomatic Meckel’s diverticulum in male and female has ratio of 3:1, with complications being more frequently encountered in males [4]. Reports from autopsy and retrospective studies show incidence ranges from 0.14 to 4.5%, 4.2% of cases were asymptomatic in a study from the U.S. [5]. A variety of surgical complications in an abdomen caused by Ascaris lumbrocoides may arise and usually occur in the children. Wandering nature of Ascaris lumbricoides after migration from their usual habitat of small intestine leads to myriad of surgical complications in the abdomen.
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