Table 1.
Clinical Description of the LATUM Cases
| Case* | Age/Sex* | Symptoms* | Signs* | Investigations* | Surgery Findings* | Surgery* | Complications* |
|---|---|---|---|---|---|---|---|
| 1 | 5y6m/M | Abd pain, vomiting & fever for 3 days | Tender and guarded lower abd | Hb: 12.9 g/dL; TLC: 10.2×109/L USG & CT scan abd: Inflammatory mass in the lower abdomen with interloop abscess Histo: Meckel's diverticulitis & secondary periappendicitis. No heterotopia | Meckel's diverticulitis with perforation and forming a mass with adjacent loops and appendix | LATUM and appendicectomy | Nil |
| 2 | 12y2m/F | Abd pain, vomiting and fever for 1 day | Tender RIF | Hb: 15.4 g/dL; TLC: 13.1×109/L Histo: Acute appendicitis and MD (No heterotopia) | Appendicitis and incidental MD | LATUM and appendicectomy | Nil |
| 3 | 5y2m/F | PR bleeding and pallor for 1 day | Fresh PR bleeding, hypotension | Hb: 9.6 g/dL; TLC: 12×109/L Histo: MD with hemorrhagic peptic ulcer at base and gastric heterotopia | MD and blood filled distal intestinal loops | LATUM | Nil |
| 4 | 2y9m/M | PR bleeding, cold hands & feet and pallor for 1 day | Pallor, melenic stools on PR | Hb: 6.6 g/dL; TLC: 14.7×109/L 99mTc scan: Consistent with MD Histo: MD with gastric & pancreatic heterotopia | MD and blood filled distal intestinal loops | LATUM | Nil |
| 5 | 12y2m/F | Abd pain, vomiting and abd distension for 4 days | Distended abd with lower abd tenderness | Hb: 14 g/dL; TLC: 11.5×109/L AXR: Distended small bowel & air fluid levels Histo: MD with congestion and ischemic changes. No heterotopia | Meso-diverticular band intestinal obstruction with congestion of dilated proximal bowel | LATUM | Adhesive IO 2 weeks later |
| 6 | 13y5m/M | Abd pain, fever and blood streaked stools for 1 day | Tender RIF with rebound tenderness | Hb: 12.5 g/dL; TLC: 11.6×109/L USG abd: Free fluid in right paracolic gutter Histo: Completely infarcted MD | Torsed MD with a narrow pedicle covered by omentum and adherent to parieties at RIF | Modified LATUM & appendicectomy | Nil |
| 7 | 11y10m/M | PR bleeding for 1 day | Pallor, melenic stools on PR | Hb: 10.8 g/dL; TLC: 17.2×109/L 99mTc scan: Consistent with MD Histo: MD with gastric heterotopia and ulceration | MD and blood filled distal intestinal loops | LATUM | Nil |
| 8 | 12y8m/M | Abd pain for 1 day | Tender RIF | Hb: 13.2 g/dL; TLC: 16.4×109/L Histo: Acute appendicitis; MD with gastric heterotopia, no ulcers | Appendicitis and incidental MD | LATUM and appendicectomy | Nil |
*
y=years, m=months, Abd=Abdomen, PR=Per-rectal, RIF=Right iliac fossa, Hb=Hemoglobin, TLC=Total leucocyte count, USG=Ultrasonogram, CT=Computed tomography, AXR=Abdominal radiograph, Histo=Histopathology, IO=Intestinal obstruction, MD=Meckel's diverticulectomy, LATUM=laparoscopic-assisted transumbilical Meckel's diverticulectomy.