BACKGROUND: Meckel's diverticulum is the most common congenital anomaly of the small bowel and is caused by the incomplete obliteration of the omphalomesenteric duct during the eighth week of gestation. METHODS: We report the case of a 51-year-old male who presented to the emergency department with epigastric pain, vomiting, and abdominal distension. Clinically, he had a high intestinal obstruction without any mechanical cause on computed tomography scan. A median laparotomy was proposed. RESULTS: An internal ileum hernia was identified twisted around a giant Meckel's diverticulum with a mesodiverticular artery, coursing from the base of the mesentery to the diverticulum. A small bowel segmental resection was performed, containing the diverticulum. Histology revealed a 15-cm long Meckel's diverticulum with no heterotopic mucosa. CONCLUSION: Small bowel obstruction due to an internal ileum hernia twisted around a giant Meckel's diverticulum with a mesodiverticular artery is very rare, and its diagnosis is challenging, requires a high level of suspicion, and it is only performed by exploratory surgery.
BACKGROUND: Meckel's diverticulum is the most common congenital anomaly of the small bowel and is caused by the incomplete obliteration of the omphalomesenteric duct during the eighth week of gestation. METHODS: We report the case of a 51-year-old male who presented to the emergency department with epigastric pain, vomiting, and abdominal distension. Clinically, he had a high intestinal obstruction without any mechanical cause on computed tomography scan. A median laparotomy was proposed. RESULTS: An internal ileum hernia was identified twisted around a giant Meckel's diverticulum with a mesodiverticular artery, coursing from the base of the mesentery to the diverticulum. A small bowel segmental resection was performed, containing the diverticulum. Histology revealed a 15-cm long Meckel's diverticulum with no heterotopic mucosa. CONCLUSION: Small bowel obstruction due to an internal ileum hernia twisted around a giant Meckel's diverticulum with a mesodiverticular artery is very rare, and its diagnosis is challenging, requires a high level of suspicion, and it is only performed by exploratory surgery.
Authors: Talal Almas; Abdulla K Alsubai; Danyal Ahmed; Muneeb Ullah; Muhammad Faisal Murad; Khadeer Abdulkarim; Eissa Sultan Alwheibi; Mohamed Alansaari; Tala Abdullatif; Sebastian Hadeed; Muhammad Omer Khan; Majid Alsufyani; Enaam Alzadjali; Arjun Samy; Mert Oruk; Mhmod Kadom; Fatemah Saleh Alhajri; Ahmed Barakat; Maen Monketh Alrawashdeh; Mohammad Said; Reem AlDhaheri; Emad Mansoor Journal: Ann Med Surg (Lond) Date: 2022-05-07
Authors: Giuseppe Evola; Enrico Piazzese; Santo Bonanno; Carla Di Stefano; Giovanni Francesco Di Fede; Luigi Piazza Journal: Int J Surg Case Rep Date: 2021-06-18