Diferencia entre revisiones de «Meckel's diverticulum»
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==Workup== | ==Workup== | ||
*Meckel's scan (test of choice) | *Meckel's scan (test of choice) | ||
==Differential Diagnosis== | |||
{{Lower GI bleeding DDX}} | |||
==Treatment== | ==Treatment== | ||
Revisión del 04:21 5 mar 2015
Background
- Most common cause of significant LGIB in children
- Due to vitelline duct not disappearing by 7 wks
Rule of 2's
- 2% of population
- 2 ft from ileocecal valve
- 2% become symptomatic
- 2 years of age (45%)
Diagnosis
- Rectal bleeding (+/- pain)
- Most common presentation in <5yrs
- May be intermittent or massive
- Obstruction (can cause intussusception)
- Diverticulitis
- Umbilical fistula
- 1/3 will perforate
Workup
- Meckel's scan (test of choice)
Differential Diagnosis
Undifferentiated lower gastrointestinal bleeding
- Upper GI Bleeding
- Diverticular disease
- Vascular ectasia / angiodysplasia
- Inflammatory bowel disease
- Infectious colitis
- Mesenteric Ischemia / ischemic colitis
- Meckel's diverticulum
- Colorectal cancer / polyps
- Hemorrhoids
- Aortoenteric fistula
- Nearly 100% mortality if untreated
- Consider in patients with gastrointestinal bleeding and known abdominal aortic aneurysms or aortic grafts
- Rectal foreign body
- Rectal ulcer (HIV, Syphilis, STI)
- Anal fissure
Treatment
- NGT
- IVF
- pRBCs prn
- Surgery consult