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Axial Torsion and Gangrene: An Unusual Complication of Meckel's Diverticulum
Hassan Bin Ajmal1, Zainab Majid2, Faryal Tahir2
1General Surgery, Dow University of Health Sciences, Karachi, PAK.
Abstract:
Meckel's diverticulum (MD), a congenital abnormality of the gastrointestinal tract, is usually found in the pediatric population younger than two years of age; hence, its incidence in adults is rare. Although MD is mostly clinically silent, in adults, it may present with intestinal obstruction and diverticulitis. The complications of MD include hemorrhage, perforation, enterolith formation, torsion, Littre's hernia, ulceration and neoplasm. Among these, torsion is one of the rarely reported complications of MD. MD being attached to the ileal mesentery or umbilicus, presence of mesodiverticular band, and the length, breadth and base diameter of the diverticulum contribute as a risk factor for torsion. A similar clinical picture of acute appendicitis must be excluded. We report a case of a 25-year-old male who presented with signs of intestinal obstruction in whom intraoperative finding of a torted MD with necrotic and twisted base was found upon emergency exploratory laparotomy.
Insights
Meckel
Area of Science:
- Gastroenterology
- Surgical Case Reports
Background:
- Meckel's diverticulum (MD) is a congenital gastrointestinal anomaly, rare in adults.
- While often asymptomatic, MD can manifest as intestinal obstruction or diverticulitis in adults.
Observation:
- A 25-year-old male presented with symptoms of intestinal obstruction.
- Intraoperative findings revealed a torted Meckel's diverticulum with a necrotic, twisted base.
Findings:
- Torsion is a rare complication of Meckel's diverticulum.
- Factors like attachment to mesentery/umbilicus and diverticulum dimensions increase torsion risk.
Implications:
- This case highlights the importance of considering Meckel's diverticulum in adult intestinal obstruction.
- Prompt diagnosis and surgical intervention are crucial for managing complications like torsion.
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