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Small Bowel Obstruction Linked to Meckel's Diverticulum: A Rare Case
Fábio Viveiros1, Nereida Monteiro2, Inês Arnaud1
1General Surgery, Local Health Unit of Alto Minho, Viana do Castelo, PRT.
Cureus
|January 15, 2025
Summary
Meckel's diverticulum, a common congenital anomaly, can cause small bowel obstruction. This case highlights its role in atypical presentations, emphasizing tailored management based on patient factors and findings.
Area of Science:
- Gastroenterology
- Surgical Pathology
- Medical Imaging
Background:
- Meckel's diverticulum (MD) is the most common congenital gastrointestinal anomaly, resulting from incomplete obliteration of the vitelline duct.
- While often asymptomatic, MD can lead to complications such as gastrointestinal bleeding, bowel obstruction, and diverticulitis.
- Risk factors for symptomatic MD include male sex, younger age (<50 years), larger diverticula (>2 cm), and ectopic tissue presence.
Observation:
- A 61-year-old male presented with acute abdominal pain and signs of small bowel obstruction.
- CT imaging confirmed intestinal obstruction, leading to exploratory laparotomy.
- An internal hernia caused by an MD adhered to the retroperitoneum was identified.
Findings:
- The patient underwent segmental small bowel resection with ileo-ileal anastomosis.
- Histological examination confirmed Meckel's diverticulum with ectopic gastric tissue.
- The MD was identified as the cause of an internal hernia leading to small bowel obstruction.
Implications:
- This case underscores Meckel's diverticulum as a potential cause of acute small bowel obstruction, particularly in patients without a history of abdominal surgery.
- Management strategies for MD should be individualized, considering patient demographics, diverticulum characteristics, and histological findings.
- Clinicians should maintain a high index of suspicion for MD in patients presenting with atypical symptoms of bowel obstruction.
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