Acute Intestinal Obstruction in Meckel’s Diverticulum
https://doi.org/10.22416/1382-4376-2020-30-1-38-41
Abstract
Aim. To present of a clinical case of a rare complication of Meckel’s diverticulum (MD).
General findings. Diseases caused by the presence of MD present one of the most common causes of an “acute abdomen” in children: up to 60% of cases of their manifestation occur in children under 10 years of age. The most common MD manifestations involve complications, such as intestinal obstruction, bleeding, diverticulitis and Litre hernia. A 9-year-old girl with abdominal pain and vomiting having appeared several hours before hospitalization was admitted to a paediatric surgical department. A few hours later, the child was operated. In the course of surgery, a strangulated intestinal obstruction was found on the mesodiverticular ligament connecting Meckel’s diverticulum with the root of the small intestine mesentery. As a result, a diverticulum resection and bowel obstruction were performed. The child was discharged with recovery.
Conclusions. An inversion of the intestine around the mesodiverticular ligament appears to be one of the most rare complications of MD. In this case, the delayed diagnosis results in the development of formidable complications in the form of necrosis and intestinal perforation, which makes Meckel’s diverticulum one of the most dangerous conditions in children.
About the Author
I. H. ShidakovRussian Federation
Paediatric Surgeon, Paediatric Surgery Department
369010, Russian Federation, Cherkessk, Griboedova st., 77a
References
1. Kozlov Yu.A., Podkamenev V.V., Novozhilov V.A. Gastrointestinal obstruction in children. National guidelines. Moscow: GEOTAR-Media Publ. House.2017:305 (In Russ.).
2. Narjis Y., Halfadl H., Agourram A., Rabbani K., Finech B. A rare internal herniation in adult: Meckel’s diverticulum. Indian J Surg. 2014;76(1):5–7. DOI: 10.1007/s12262-012-0544-2
3. Keese D., Rolle U., Gfroerer S., Fiegel H. Symptomatic Meckel’s diverticulum in pediatric patients-case reports and systematic review of the literature. Front Pediatr. 2019;7:267. DOI: 10.3389/fped.2019.00267
4. Altaf A., Aref H. A case report: Cecal volvulus caused by Meckel’s diverticulum. Int J Surg Case Rep. 2014;5(12):1200–2. DOI: 10.1016/j.ijscr.2014.11.038
5. Tenreiro N., Moreira H., Silva S., Madureira L., Gaspar J., Oliveira A. Unusual presentation of a Meckel’s diverticulum: A case report. Int J Surg Case Rep. 2015;16:48–51. DOI: 10.1016/j.ijscr.2015.09.013
6. García-Quijada García J., Bustamante Recuenco C., Carabias Hernández A., Valle Rubio A. Case report: Diverticulitis complicating a giant Meckel’s divertuculum. Int J Surg Case Rep. 2019;65:209–12. DOI: 10.1016/j.ijscr.2019.10.074
7. Wu S.Y., Ho M.H., Hsu S.D. Meckel’s diverticulum incarcerated in a transmesocolic internal hernia. World J Gastroenterol. 2014;20(37):13615–9. DOI: 10.3748/wjg.v20.i37.13615
8. Dreyer S., Kaczynski J., Hrobar P., Collins P. Reverse intestinal rotation: a rare case of volvulus around a vitelline duct remnant. BMJ Case Rep. 2014;2014. DOI: 10.1136/bcr-2014-204107
9. Xanthis A., Hakeem A., Safranek P. Laparoscopic management of terminal ileal volvulus caused by Meckel’s diverticulum. Ann R Coll Surg Engl. 2015;97(3):e47–9. DOI: 10.1308/003588414X14055925061234
10. Omole P.W., Mujinga D.T., Lubosha N.A., Mujinga I.M.W., Ntanga D.I. Intestinal occlusion due to Meckel’s diverticulum: a case study. Pan Afr Med J. 2019;32:117. DOI: 10.11604/pamj.2019.32.117.16523
11. Wang M.Q., Lee M.Y., El Teo H. Ultrasound in the evaluation of necrotic bowel in children: A pictorial essay. Ultrasound. 2019;27(4):207–16. DOI: 10.1177/1742271X18814864
12. Yagnik V.D. Ileal knotting secondary to a mesodiverticular band associated with axial torsion of a Meckel’s diverticulum and small bowel volvulus. Ci Ji Yi Xue Za Zhi. 2018;30(2):124–5. DOI: 10.4103/tcmj.tcmj_117_17
13. Timerbulatov M.V., Timerbulatov Sh.V., Sakhautdinov V.G. Meckel’s diverticulum in adults and children. Endoscopic surgery. 2017;23(2):61–6 (In Russ.). DOI: 10.17116/endoskop201723261-66
14. Korovin S.A., Dzyadchik A.V., Allahverdiyev I.S., Zykin A.P. and Sokolov Yu.Yu. The effectiveness of laparoscopic technologies in children with Meckel’s diverticulum. Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2016; 6 (4): 28–36 (In Russ.).
15. Wong C.S., Dupley L., Varia H.N., Golka D., Linn T. Meckel’s diverticulitis: a rare entity of Meckel’s diverticulum. J Surg Case Rep. 2017 Jan 6;2017(1). PII: rjw225. DOI: 10.1093/jscr/rjw225
Review
For citations:
Shidakov I.H. Acute Intestinal Obstruction in Meckel’s Diverticulum. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2020;30(1):38-41. (In Russ.) https://doi.org/10.22416/1382-4376-2020-30-1-38-41