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Almas T, Alsubai AK, Ahmed D, Ullah M, Murad MF, Abdulkarim K, Alwheibi ES, Alansaari M, Abdullatif T, Hadeed S, Khan MO, Alsufyani M, Alzadjali E, Samy A, Oruk M, Kadom M, Alhajri FS, Barakat A, Alrawashdeh MM, Said M, AlDhaheri R, Mansoor E. Meckel's diverticulum causing acute intestinal obstruction: A case report and comprehensive review of the literature. Ann Med Surg (Lond) 2022; 78:103734. [PMID: 35592821 PMCID: PMC9110976 DOI: 10.1016/j.amsu.2022.103734] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 05/01/2022] [Accepted: 05/04/2022] [Indexed: 12/05/2022] Open
Abstract
Introduction Meckel's diverticulum is a congenital anomaly that is often detected incidentally. When it presents symptomatically, it causes painless gastrointestinal bleeding. Nevertheless, in rare instances, it can cause acute intestinal obstruction, often obscuring the true clinical picture. Case presentation A 31-year-old male presented to the emergency department with a 24-h history of unremitting nausea, biliary emesis, abdominal distension, and absolute constipation. After ruling out the most common etiologies of acute bowel obstruction, radiological imaging was obtained and was suggestive of meckel's diverticulum. Laparoscopic meckel's diverticulectomy was performed, with the subsequent histopathological analysis confirming ectopic gastric tissue. Discussion Meckel's diverticulum occurs consequent to incomplete obliteration of the vitelline or omphalomesenteric duct, which connects the developing intestines to the yolk sac. It is found in roughly 2% of the population, of which only about 4% may become symptomatic due to any number of complications. Specifically, small bowel obstruction (SBO) and diverticulitis secondary to ectopic gastric or pancreatic tissue are the most common presentations of symptomatic MD. Conclusion Although relatively rare in adults, MD should be considered in the list of differentials in patients with intussusception leading to SBO, especially on a background history unremarkable for the most common etiologies causing SBO including post-operative adhesions and hernias.
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Affiliation(s)
- Talal Almas
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | - Danyal Ahmed
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Muneeb Ullah
- Maroof International Hospital, Islamabad, Pakistan
| | | | | | | | | | | | | | | | | | | | - Arjun Samy
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Mert Oruk
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Mhmod Kadom
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | - Ahmed Barakat
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | - Mohammad Said
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | - Emad Mansoor
- Division of Gastroenterology and Liver Disease, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
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Ali F, Mohammed RA, Ali P, Roop L. Retrograde Intussusception and Giant Meckel’s Diverticulum: An Uncommon Encounter. Cureus 2022; 14:e25315. [PMID: 35755562 PMCID: PMC9227733 DOI: 10.7759/cureus.25315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2022] [Indexed: 11/05/2022] Open
Abstract
Retrograde intussusception (RINT) and giant Meckel’s diverticulum (MD) are both rare pathologies and are seldom encountered in surgical practice. Thus, it is exceptional for both conditions to be seen in the same patient, with very few published case reports in the paediatric population. This case describes a three-month-old male who was referred to our paediatric surgery unit following a diagnosis of intussusception on an ultrasound scan. The patient presented to the paediatric emergency department one day prior with a clinical history of fever, cough, vomiting and irritability. After resuscitation, the patient was admitted for overnight observation in the paediatric ward. However, the patient’s symptoms persisted with notable abdominal distension. Abdominal X-ray (AP erect) showed features of small bowel obstruction, while abdominal ultrasound showed a concentric mass in the right upper quadrant consistent with intussusception. Following this diagnosis of intussusception, pneumatic enema reduction under ultrasound guidance was attempted but proved unsuccessful. The patient was then taken for emergency laparotomy. At surgery, an ileo-ileal RINT with a proximal giant MD was discovered. Successful manual reduction of the RINT and wedge resection of the giant MD with primary ileo-ileal anastomosis was performed. The postoperative recovery and follow-up were uneventful.
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Khoei S, Oliaie Rezaei N, Raji H, Zamani F. Closed loop right colon ischemia caused by omphalomesenteric band and Meckle's diverticulum. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2022. [DOI: 10.1016/j.epsc.2022.102236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Maree G, Nasser M. Intestinal obstruction due to a rare tumor in the meckel's diverticulum in a 10-month-old boy. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2022. [DOI: 10.1016/j.epsc.2022.102210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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