Abstract

CAPELAO, Gustavo et al. Intestinal Obstruction by Giant Meckel’s Diverticulum. GE Port J Gastroenterol [online]. 2017, vol.24, n.4, pp.183-187. ISSN 2341-4545.  https://doi.org/10.1159/000452690.

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.

Keywords : Intestinal obstruction; Meckel’s diverticulum; Internal hernia; Mesodiverticular artery.

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