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Unusual presentation of obscure Meckel diverticulum treated with robot-assisted diverticulectomy: A case report
Sagar Pandey1, Miao Fan, Zhe Xu
1Department of Radiology Department of Pediatric Surgery Department of Pathology, The First Affiliated Hospital of Sun Yat-sen University Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China.
Introduction:
Meckel diverticulum (MD) is the most common congenital abnormality of gastrointestinal tract. Tough believed to occur in 2% of population, most of them remain veiled because majority are clinically asymptomatic and remain obscure in radiological examination.
Clinical Findings And Diagnosis:
A 26-year-old male with episodic black colored stool since last 10 years. Tough symptomatic, diagnosis of pathological lesion, and the bleeding site could not be established with any of the sophisticated diagnostic technique. After 10 years, it was finally diagnosed as MD with careful observation of bowel loops on computed tomography enterography (CTE) where remnant of vitelline vessel and hyper-enhancing nodule are seen along the wall of diverticular loop.
Interventions And Outcomes:
The patient underwent robot assisted laparoscopic surgery with excision of diverticular loop. To the best of our knowledge, this robot-assistant Meckel diverculectomy is probably the first reported surgical procedure in PubMed. Follow-up for 3 month showed no complication or recurrence.
Conclusion:
Every case is unique and we must be aware and remain alert in tracing the possible morphological variation of the case. Here, we present one unique but rare feature of MD, which helped us in making diagnosis.
Insights
This case highlights a rare Meckel diverticulum (MD) diagnosis in a young male with chronic gastrointestinal bleeding. Advanced imaging confirmed the MD, leading to successful robot-assisted laparoscopic surgery.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Diagnostic Imaging
Background:
- Meckel diverticulum (MD) is a common congenital gastrointestinal anomaly, often asymptomatic and difficult to diagnose radiologically.
- Accurate diagnosis is crucial for managing symptomatic cases and preventing complications.
Observation:
- A 26-year-old male presented with a decade of intermittent melena, eluding conventional diagnostic methods.
- Computed tomography enterography (CTE) revealed characteristic findings of MD, including a remnant vitelline vessel and a hyper-enhancing nodule.
Findings:
- The patient underwent successful robot-assisted laparoscopic Meckel diverculectomy, a potentially novel surgical approach.
- Post-operative follow-up showed no complications or recurrence at three months.
Implications:
- This case underscores the importance of considering rare presentations of MD, even in the presence of advanced diagnostic tools.
- Careful radiological assessment, particularly CTE, is vital for identifying subtle MD features.
- Robot-assisted surgery offers a minimally invasive option for MD treatment.
