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Torsion of Atypical Meckel's Diverticulum Treated by Laparoscopic-Assisted Surgery
Atsushi Kohga1, Kimihiro Yamashita1, Yuto Hasegawa1
1Division of Surgery, Fujinomiya City General Hospital, Fujinomiya, Japan.
Introduction:
Meckel's diverticulum (MD) is the most common congenital anomaly of the intestine, with an incidence of 2~4%. Of those, only 2% of patients with MD are symptomatic. Torsion of MD is extremely rare, and only a dozen cases have been previously reported.
Case Report:
The patient was a 49-year-old male who presented to our emergency room with a chief complaint of lower abdominal pain. Computed tomography imaging revealed an irregular polycystic mass connected to the small intestine that measured 7.5 cm in a diameter. A laparoscopic-assisted partial resection of the jejunum was performed. The lesion was found to have caused torsion and was located 130 cm from the ileocecal valve. The specimen was polycystic in appearance and showed communicating links with the submucosal layer of jejunum but not with the lumen. The pathological diagnosis was a torsion of an atypical presentation of MD.
Conclusion:
This case was different from typical cases of MD in that it was located on significantly oral side and had the appearance of polycystic morphology.
Insights
Torsion of Meckel
Area of Science:
- Gastroenterology
- Surgical Pathology
Background:
- Meckel's diverticulum (MD) is a common congenital intestinal anomaly, affecting 2-4% of the population.
- Symptomatic presentations of MD are rare, occurring in only 2% of cases.
- Torsion of Meckel's diverticulum is an exceptionally infrequent complication.
Observation:
- A 49-year-old male presented with lower abdominal pain.
- CT imaging identified a 7.5 cm polycystic mass connected to the jejunum.
- The mass was surgically resected and diagnosed as torsion of an atypical Meckel's diverticulum.
Findings:
- The torsion occurred 130 cm from the ileocecal valve, an unusually oral location.
- The diverticulum exhibited a polycystic morphology with submucosal connections.
- Pathological analysis confirmed torsion of an atypical Meckel's diverticulum.
Implications:
- This case highlights an atypical presentation of Meckel's diverticulum torsion.
- The unusual location and morphology underscore the importance of considering rare diagnoses in abdominal pain.
- Surgical intervention, such as laparoscopic-assisted resection, is crucial for managing symptomatic MD torsion.
