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Mesenteric Meckel's diverticulum: an unusual cause of small bowel intussusception

Syed Hussain Abbas1, Khalid Akbari1, John Mason1

  • 1Royal Berkshire Hospital, Reading, Berkshire, UK.

BMJ Case Reports
|April 10, 2016
PubMed

Insights

A rare case of mesenteric Meckel's diverticulum (MD) was identified in a 45-year-old woman. This congenital anomaly, typically found elsewhere, caused intussusception and anemia, resolving after surgical resection.

Area of Science:

  • Gastroenterology
  • Surgical Pathology
  • Congenital Anomalies

Background:

  • Meckel's diverticulum (MD) is the most frequent congenital anomaly of the small intestine, occurring in 1-4% of the population.
  • Typical MDs are located antimesenterically, two feet proximal to the ileocecal valve, with distinct mesenteric blood supply and full-thickness intestinal wall involvement.
  • Mesenteric MDs, arising from the mesenteric border, are exceptionally rare in surgical literature.

Observation:

  • A 45-year-old woman presented with a six-month history of intermittent central abdominal pain and microcytic anemia.
  • Initial CT scans were inconclusive, leading to an elective diagnostic laparoscopy.
  • Intraoperatively, small bowel intussusception was observed approximately 40 cm proximal to the ileocecal valve.

Findings:

  • Macroscopic examination of the resected small bowel segment revealed an outpouching originating from the mesenteric border.
  • Histopathological analysis confirmed the presence of a mesenteric Meckel's diverticulum.
  • The patient experienced complete symptom resolution and no surgical complications postoperatively.

Implications:

  • This case highlights the importance of considering atypical presentations of Meckel's diverticulum, even when arising from the mesenteric border.
  • Accurate diagnosis and surgical management are crucial for resolving symptoms associated with mesenteric MD.
  • Further investigation into the embryological and clinical spectrum of mesenteric MD may be warranted.

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