Meckel's Diverticulum Enterolith: An Extremely Rare Cause of Intestinal Obstruction

Meckel's Diverticulum Enterolith: A Rare Cause of Perforation and Small Bowel Obstruction Presenting as Acute Abdomen

Meckel’s diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract. MD enteroliths are an uncommon entity that could rarely present with complications.

We, herein, present a case of a 56-year-old man who presented with severe abdominal pain. Preoperative CT showed an inflamed structure with central calcification connected to distal ileum lumen with an air pouch associated with small bowel obstruction. Upon laparotomy, a perforated MD was found with phlegmon formation. He underwent resection of the loops containing MD with end-to-end anastomosis. 

This highlights the importance of radiological imaging in preoperative diagnosis of these conditions which should be kept in mind if we find a calcified lesion in an inflamed diverticulum around the midline region.

Meckel's Enterolith Causing Small Bowel Obstruction: A Useful Solution to a Unique Problem

Meckel’s diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract. Its course is usually benign but may also result in complications requiring surgical intervention. A diverticulum may also permit the removal of intraluminal objects without bowel resection and anastomosis.

A woman in her 50s was found to have a mechanical small bowel obstruction secondary to an intraluminal mass within the terminal ileum. On exploration, an MD was encountered proximal to the mass. A diverticulectomy was performed after maneuvering the enterolith into the diverticulum.

Meckel’s diverticulum with an associated enterolith is a rare cause of small bowel obstruction. Historic imaging may show long-standing stones in the bowel lumen and provide a diagnostic clue. Diverticulectomy may be performed to reduce the risks of small bowel resection and anastomosis. This technique can be used for other intraluminal objects requiring removal in the presence of an MD.