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Small Bowel Volvulus Secondary to Meckel's Diverticulum With Meso-Diverticular Band: A Case Report and Literature
Solomon Raj Vasudayan1, Guo Hou Loo1, Mogaraj Sellapan1
1Upper Gastrointestinal and Metabolic Surgery Unit, Department of Surgery, Faculty of Medicine, The National University of Malaysia, Kuala Lumpur, MYS.
Abstract:
Small bowel volvulus (SBV) is a rare yet potentially fatal cause of intestinal obstruction characterized by the twisting of the small intestine around its mesenteric axis. Prompt diagnosis and timely intervention are critical to preventing complications such as bowel ischemia, perforation, and sepsis. SBV can occur without a clear underlying pathology (idiopathic) or be associated with anatomical anomalies, such as Meckel's diverticulum (MD), accompanied by a meso-diverticular band (MDB). We report a rare case of SBV in an adult woman, resulting from MD complicated by the presence of an MDB. She presented with a two-day history of severe central abdominal pain, distension, vomiting, and obstipation. Imaging revealed features consistent with SBV without definitive identification of the underlying cause preoperatively. Urgent exploratory laparotomy was performed, identifying MD with MDB as the causative factors. The patient underwent small bowel resection and excision of MD along with the MDB. Surgical intervention remains the cornerstone of management for SBV, with early operative treatment crucial to minimizing morbidity and mortality. Although traditional laparotomy remains common, laparoscopic approaches are emerging as effective alternatives, offering potential advantages in diagnosis and management. This case underscores the importance of considering MD with MDB in adults presenting with SBV and highlights key surgical management strategies.
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