Meckel’ s diverticulitis complicated by acute small intestinal obstruction

Case contributed by Fakhry Mahmoud Ebouda
Diagnosis certain

Presentation

Acute severe abdominal pain, epigastric and lower abdominal tenderness.

Patient Data

Age: 55 years
Gender: Male

Mild to moderate dilation of the small bowel loops with associated right iliac fossa transitional zone. It is associated with crowded bowel loops, mesenteric congestion and fat stranding within the right abdominal quadrant. It is intimately related to small blind ending outpouching with a thick enhancing wall,  with an associated small amount of peritoneal reflection-free fluid. 

The patient underwent surgery where inflamed Meckel's diverticulum with consequent small bowel obstruction.

Annotated images of Meckel diverticulum.

Case Discussion

Meckel's diverticulum is a true diverticulum also known as a vestigial remnant of the omphalomesenteric duct. It is considered the most common structural congenital anomaly of the GIT. The mechanism of obstruction may be due to trapping of the bowel loop by mesodiverticular band, extension into a hernial sac (Littre's hernia) or intussusception. Hemorrhage is the most common complication of Meckel’s diverticulumIntestinal obstruction is the second most common complication of Meckel's diverticulum.

 

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