Related Experiment Video
Updated: Apr 16, 2026
Laparoscopic Repair of Para-Esophageal Hernia Using Absorbable Biosynthetic Mesh
Published on: September 11, 2021
Meckel's diverticulum mesentery along with its band forming a hernial sac: A rare case of internal herniation
Paras K Pandove1, Ashish Moudgil1, Megha Pandove1
1Department of Surgery, Rajindra Hospital/Government Medical College, Patiala 147001, Punjab, India.
Introduction:
Meckel's diverticulum is the most common congenital gastrointestinal anomaly. However, only 2% of cases are symptomatic. It can cause intestinal obstruction by various mechanisms as volvulus, adhesions, Littre's hernia, intussusception.
Case Presentation:
An unusual case of internal herniation of small bowel loops into complete hernia sac formed by unusual mesentery of Meckel's diverticulum which was present upto the adhesive band, extending from tip of the Meckel's diverticulum to the adjacent mesentery of small intestine leading to small bowel obstruction (SBO). Diverticulectomy with resection of adjacent ileum with ileo-ileal anastomosis was done.
Discussion:
Internal herniation by MD leading to SBO is an extremely rare complication. In literature, cases of internal hernia through mesentry of Meckel's diverticulum, through mesodiverticular band, adhesion of inflamed end of MD to corresponding base of mesentry, fibrous cord extending upto umblical wall have been reported but in our case, patient had both adhesion band along with internal herniation into sac formed by unusual mesentry of the meckel's diverticulum and the adhesion band. Preoperative diagnosis is often difficult with only 6-12% of cases diagnosed correctly. Surgical intervention is indicated for patients with intestinal obstruction or high risk of incarceration.
Conclusion:
Meckel's diverticulum causing internal hernia is rare event. It's presentation due to herniation of bowel loops into sac formed by mesentery attached to diverticulum and the adhesion is rarest, with non specific signs and symptoms. Early diagnosis and prompt treatment prevent further complications.
Insights
Meckel's diverticulum can cause rare internal hernias leading to small bowel obstruction. This case highlights a unique presentation involving a hernia sac formed by the diverticulum's mesentery and an adhesive band, emphasizing the need for prompt surgical intervention.
Area of Science:
- Gastroenterology
- Surgical Pathology
- Congenital Anomalies
Background:
- Meckel's diverticulum is the most common congenital gastrointestinal anomaly, but symptomatic cases are rare (2%).
- It can lead to intestinal obstruction through mechanisms like volvulus, adhesions, Littre's hernia, and intussusception.
Purpose of the Study:
- To report an extremely rare case of internal herniation caused by Meckel's diverticulum.
- To describe a unique mechanism of small bowel obstruction involving an unusual hernia sac and adhesive band.
Main Methods:
- A case of internal herniation and small bowel obstruction (SBO) due to Meckel's diverticulum was identified.
- Surgical intervention included diverticulectomy, resection of adjacent ileum, and ileo-ileal anastomosis.
Main Results:
- The patient experienced SBO due to internal herniation into a sac formed by the Meckel's diverticulum's mesentery and an adhesive band.
- Preoperative diagnosis of such rare complications is challenging, with accuracy rates reported between 6-12%.
Conclusions:
- Internal herniation through the mesentery of Meckel's diverticulum, especially with an associated adhesive band, is an exceptionally rare cause of SBO.
- Early diagnosis and prompt surgical intervention are crucial for managing this rare complication and preventing adverse outcomes.
More Related Videos
Related Concept Videos
01:15Development of the Lymphatic System
The first lymph sacs to form are the paired jugular lymph sacs located at the junction of the internal jugular and subclavian veins. From these sacs, lymphatic capillary plexuses extend to the thorax, upper limbs, neck, and head, eventually forming lymphatic vessels. Each jugular lymph sac maintains a...
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
01:22Appendicitis-I: Introduction
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
01:09Large Intestine
The ileocecal sphincter, a mucous membrane fold, guards the opening from the ileum to the large intestine. This valve permits material from the small intestine to pass into the large intestine. Attached to the ileocecal valve is the cecum. This small pouch, approximately 6 cm long, has a twisted, coiled tube known as...
01:21Peritoneum
Anatomy of the Peritoneum
The peritoneum is divided into two layers: the parietal peritoneum and the visceral...
01:24Esophagus
The movement of edibles from the pharynx into the esophagus is facilitated by the upper esophageal sphincter, which is formed primarily by the...