Intussusception of a Meckel's Diverticulum in a 58-Year-Old Female: A Case Report

Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract. Although it is often asymptomatic in adults, it can present with severe complications such as diverticulitis, hemorrhage, or intestinal obstruction. Due to its clinical presentation, it frequently mimics acute appendicitis, posing a significant diagnostic challenge. A 58-year-old female with no relevant surgical history presented to the emergency department with a two-day history of progressive sharp pain in the right iliac fossa, fever, and positive peritoneal signs. Computed tomography suggested complicated acute appendicitis. However, emergency exploratory laparotomy revealed a gangrenous Meckel's diverticulum located 70 cm from the ileocecal valve, and intraoperatively, an intussusception of the diverticulum was identified, causing secondary intestinal obstruction. Wedge resection was executed, given the small scale of the lesion, and to minimize bowel trauma, thereby reducing the extent of the incision and requiring fewer suture stitches, along with intestinal decompression. The patient had an uneventful recovery and was discharged on the fourth postoperative day. Meckel's diverticulitis in the adult population is rare and often represents an intraoperative challenge. While CT scans are valuable for ruling out other pathologies, they may not always provide a definitive preoperative diagnosis. An intussusception of the diverticulum leads to bowel obstruction secondary to impaired peristalsis, a condition exacerbated by the increase in peristaltic waves. Surgical intervention remains the definitive treatment, with options ranging from simple diverticulectomy to segmental bowel resection depending on the diverticulum's characteristics and the state of the adjacent tissue. Although more prevalent in children, Meckel's diverticulum must be included in the differential diagnosis of adult patients presenting with symptoms of acute abdomen or intestinal obstruction. Early surgical exploration is critical to achieving a definitive diagnosis and preventing further morbidity. Intussusception is an extremely rare finding in a Meckel's diverticulum; it is important to know this case presentation, the pathophysiology, and diagnosis, so the surgical management can be effective for the patient's benefit.