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Meckel's Enterolith Causing Small Bowel Obstruction: A Useful Solution to a Unique Problem
Gabriel De la Cruz Ku1, Erek Nelson1, Rolando Calderon1
1General Surgery, Mayo Clinic, Rochester, USA.
Abstract:
Meckel's diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract. Its course is usually benign but may also result in complications requiring surgical intervention. A diverticulum may also permit the removal of intraluminal objects without bowel resection and anastomosis. A woman in her 50s was found to have a mechanical small bowel obstruction secondary to an intraluminal mass within the terminal ileum. On exploration, an MD was encountered proximal to the mass. A diverticulectomy was performed after maneuvering the enterolith into the diverticulum. Meckel's diverticulum with an associated enterolith is a rare cause of small bowel obstruction. Historic imaging may show long-standing stones in the bowel lumen and provide a diagnostic clue. Diverticulectomy may be performed to reduce the risks of small bowel resection and anastomosis. This technique can be used for other intraluminal objects requiring removal in the presence of an MD.
Insights
Meckel's diverticulum (MD) can cause rare small bowel obstructions due to intraluminal masses like enteroliths. A diverticulectomy successfully removed the mass, avoiding bowel resection.
Area of Science:
- Gastroenterology
- Surgical Innovation
Background:
- Meckel's diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract.
- While often asymptomatic, MD can lead to complications necessitating surgical intervention.
Observation:
- A mechanical small bowel obstruction was diagnosed in a patient due to an intraluminal mass.
- Surgical exploration revealed a Meckel's diverticulum proximal to the obstructing mass.
Findings:
- The intraluminal mass was identified as an enterolith within the Meckel's diverticulum.
- A diverticulectomy was successfully performed by maneuvering the enterolith into the diverticulum, avoiding bowel resection and anastomosis.
Implications:
- Meckel's diverticulum with an enterolith is a rare but significant cause of small bowel obstruction.
- Diverticulectomy offers a valuable surgical approach to manage intraluminal objects within MD, potentially preventing more extensive bowel surgery.
- Preoperative imaging may provide diagnostic clues for long-standing enteroliths within the bowel lumen.
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