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Small Bowel Obstruction due to a Giant Meckel's Diverticulum
Andreas Minh Luu1, Kirsten Meurer1, Torsten Herzog1
1Department of General and Visceral Surgery, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany.
Background:
Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract, with an average length of 3 cm. Complications occur in 6.4% and most commonly include inflammation and gastrointestinal bleeding. Preoperative diagnosis is demanding and achieved in 4%.
Case Report:
A 34-year-old otherwise healthy patient presented with an acute abdomen due to small bowel obstruction. Computed tomography scan could not identify the underlying cause. Emergency laparotomy was performed, and a torqued giant Meckel's diverticulum measuring 17 cm was found as the underlying cause for the small bowel obstruction. Resection of the affected ileum segment and ileo-ileal reconstruction were performed. The postoperative course was uneventful.
Conclusion:
In extremely rare cases, small bowel obstruction in an otherwise healthy patient might be caused by torsion of a symptomatic giant Meckel's diverticulum.
Insights
Giant Meckel's diverticulum, a rare congenital anomaly, can cause small bowel obstruction due to torsion. This case highlights the importance of considering this in acute abdominal presentations.
Area of Science:
- Gastroenterology
- Surgical Pathology
Background:
- Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract.
- Complications like inflammation and bleeding occur in 6.4%, with preoperative diagnosis challenging (4%).
Observation:
- A 34-year-old patient presented with acute abdomen and small bowel obstruction.
- Computed tomography was inconclusive; emergency laparotomy revealed a 17 cm torqued giant Meckel's diverticulum.
Findings:
- Surgical resection of the affected ileum and reconstruction were performed successfully.
- The patient experienced an uneventful postoperative recovery.
Implications:
- Torsion of a symptomatic giant Meckel's diverticulum is an extremely rare cause of small bowel obstruction.
- This case underscores the need for surgical consideration in unexplained acute abdomen presentations.
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