Related Experiment Video
Updated: Aug 9, 2025
Three-Dimensional Printing of a Complex Aortic Anomaly
Published on: November 1, 2018
A Case of Torsion of Meckel's Diverticulum
Katsudai Shirakabe1, Ken Mizokami1
1General Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, JPN.
Abstract:
Meckel's diverticulum is the most common congenital abnormality of the gastrointestinal tract. Histologically, it is a true diverticulum comprising all four layers of the intestinal tract. The complications associated with Meckel's diverticulum include bleeding, bowel obstruction, and intussusception. Torsions are an extremely rare complication. The patient was a 15-year-old boy who presented to the emergency department with acute-onset lower abdominal pain and was admitted to the hospital for a follow-up of abdominal pain due to nonspecific imaging findings. The symptoms of the patient worsened 12 hours after admission, and he underwent emergency laparoscopic surgery. A large Meckel's diverticulum with torsion and necrosis was observed 30 cm proximal to the ileocecal valve. The diverticulum was twisted around the base of the neck. Subsequently, wedge resection of the small intestine, including the diverticulum, was performed. Stem torsion is a rare complication of Meckel's diverticulum. As definitive preoperative diagnosis was difficult to obtain through imaging studies, early laparoscopic surgery was considered effective.
Insights
Meckel
Area of Science:
- Gastroenterology
- Pediatric Surgery
Background:
- Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract, characterized histologically as a true diverticulum involving all four intestinal layers.
- Common complications include bleeding, bowel obstruction, and intussusception, with torsion being an extremely rare occurrence.
Observation:
- A 15-year-old boy presented with acute lower abdominal pain and nonspecific imaging findings.
- Symptoms worsened 12 hours after admission, necessitating emergency laparoscopic surgery.
- A large Meckel's diverticulum with evidence of torsion and necrosis was identified 30 cm proximal to the ileocecal valve, twisted at its base.
Findings:
- The surgical procedure involved a wedge resection of the small intestine to remove the affected diverticulum.
- Stem torsion of Meckel's diverticulum was confirmed as the cause of the patient's symptoms.
- Definitive preoperative diagnosis via imaging was challenging.
Implications:
- Early laparoscopic surgery is an effective treatment for complicated Meckel's diverticulum, especially when diagnosis is uncertain.
- This case highlights the importance of considering rare complications like torsion in the differential diagnosis of acute abdominal pain in adolescents.
Related Concept Videos
01:26Esophageal Strictures-II: Clinical Features and Management
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
01:30Esophageal Strictures-I: Introduction
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...