Giant Meckel's diverticulum torsion that mimics adnexal pathology

Area of Science:

• Gastroenterology
• Surgical Pathology

Background:

• Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract, affecting 1-3% of the population.
• Often asymptomatic, diagnosis frequently occurs upon complication development.
• Complications include obstruction, intussusception, and volvulus, but torsion of a free Meckel's diverticulum is rare.

Purpose of the Study:

• To report a rare case of a 23-year-old female presenting with pelvic pain due to a giant Meckel's diverticulitis with bowel loop torsion.
• To highlight the diagnostic challenges when Meckel's diverticulum mimics adnexal pathology.
• To emphasize the possibility of Meckel's diverticulum torsion without adhesions.

Main Methods:

• Case report of a 23-year-old female with acute abdomen and pelvic pain.
• Diagnostic workup including physical examination and imaging studies.
• Surgical intervention (laparotomy) revealing giant Meckel's diverticulitis and torsion of ischemic bowel loops.

Main Results:

• A giant Meckel's diverticulitis was identified as the cause of acute abdomen and pelvic pain.
• Torsion of ischemic bowel loops secondary to the mobilized diverticulum was observed.
• The clinical presentation mimicked adnexal pathology, complicating diagnosis.

Conclusions:

• Meckel's diverticulum, even when free and unattached, can cause bowel torsion.
• Pelvic Meckel's diverticulum can present with symptoms mimicking gynecological emergencies.
• Consider Meckel's diverticulum in the differential diagnosis of acute abdomen with pelvic pain, especially when adnexal pathology is suspected.