eP245 - A Rare Presentation of Meckel's Diverticulum: A Case Report

ePoster Presenter(s)

• 

  Christina Schott (she/her/hers)

  Medical Student
  George Washington University School of Medicine and Health Sciences
  George Washington University School of Medicine and Health Sciences
  WASHINGTON, DC, United States

  All of the relevant financial relationships listed below have been mitigated.
  This individual has no financial relationships with ineligible companies.

Author(s)

• KR

  Katherine M. Rangoussis, BS

  Medical Student
  George Washington University School of Medicine
  Washington, District of Columbia, United States

  Disclosure information not submitted.
• AV

  Alejandro Velasquez, BS

  Medical Student
  The George Washington University
  Washington, District of Columbia, United States

  Disclosure information not submitted.
• KP

  Kunj Patel, BA

  Medical Student
  George Washington University School of Medicine and Health Sciences
  Washington, District of Columbia, United States

  Disclosure information not submitted.
• YB

  Yusuf Bade, BA

  Medical Student
  The George Washington University School of Medicine and Health Sciences
  Washington, District of Columbia, United States

  Disclosure information not submitted.
• JE

  Jana El-Sayed, BS

  Medical Student
  George Washington University School of Medicine and Health Sciences
  Springfield, Virginia, United States

  Disclosure information not submitted.
• JL

  Jacob Lambdin, MD

  Surgery Resident
  George Washington University
  Falls Church, Virginia, United States

  Disclosure information not submitted.

Senior Author(s)

• MN

  Matthew Ng, MD, FACS

  Assistant Professor of Surgery
  George Washington University Hospital
  Washington, District of Columbia, United States

  Disclosure information not submitted.

Purpose/Background: Meckel’s diverticulum (MD) is the most common congenital gastrointestinal anomaly. MD is the result of incomplete obliteration of the omphalomesenteric duct. While often an incidental finding in adults, MD may harbor malignancies and management remains controversial.Methods/Interventions: A 77-year-old male presented with vague abdominal pain. Imaging revealed a 13x14cm mass in the right lower quadrant suspected to be originating from the mesentery. After discussion, the patient was taken to the operating room for resection of the mesenteric mass. The mass was found to be emanating from a previously undiagnosed Meckel’s diverticulum. The mass was then removed en-bloc by way of a segmental bowel resection with removal of the associated mesentery. The patient tolerated the procedure well and recovered uneventfully. Final pathology revealed a high grade undifferentiated carcinoma.Results/Outcomes: Less than 3.2% of MD patients present with malignancy, with neuroendocrine tumors being the predominant type (Malderen et al., 2018). Previous recommendations against incidental diverticulectomy were based on higher risk of procedure complications (8%) compared to MD complications (2-4%). But, more recent recommendations have advocated for a case-by-case approach with factors such as younger age, palpable/visual abnormality, or previous symptoms due to MD favoring resection to reduce risk of a tumor due to the poor overall prognosis of primary malignancies of MD.Conclusion/

Discussion: Management of malignancies arising from Meckel’s diverticulum can present both diagnostic and therapeutic challenges. Clinicians must be aware of the fact that MD may harbor various malignancies when deciding on management strategies for patients MD.PseudoaneurysmSplenic artery pseudoaneurysm fistualized to transverse colon