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[Rare Clinical Case of a Small Intestine Ileus Following an Invaginated Meckel's Diverticulum]
Claudia Schadow1, Hanna Schmidt1, Alexander Schorcht2
1Klinik für Allgemein-, Viszeral-, Gefäß- & Transplantationschirurgie, Universitätsklinikum Magdeburg A.ö.R., Magdeburg.
Medical History And Clinical Findings:
A 43-year old male patient was admitted because of diffuse abdominal discomfort for two days, which had started in the upper abdomen; medical history, no previous surgical interventions at the abdomen.
Investigations:
Gastroscopy and abdominal ultrasound revealed only a mild gastritis. Laboratory parameters: showed only a slight leucocytosis (10 610/µL). On the 1st day of the hospital stay, the patient developed a worsening of the abdominal symptoms with distended abdomen, sounding bowel movements and recurrent vomiting, which were interpreted as acute abdomen by the surgeon on call leading to the indication of a surgical intervention. CT scan revealed an intraluminal tumor.
Diagnosis:
Suspicion of a mechanical ileus by an obstructing tumor of the small intestine.
Therapy:
Median laparotomy of the lower abdomen revealed an invagination at the terminal ileum - after devagination, an invaginated Meckel's diverticulum was found. This was resected at its basis and the ileal wall was transversally sutured.
Course:
The postoperative course was uneventful.
Discussion (Conclusion):
An invaginated Meckel's diverticulum belongs rather to the less frequent causes of an ileus of the small intestine and an unclear / acute abdomen in adults.