Adult intussusception caused by an inverted meckel diverticulum

Abstract

Adult intussusception caused by an inverted Meckel diverticulum is rare. We report a 55-year-old Japanese man with intussusception. He was admitted to our hospital with vomiting and abdominal pain. The abdomen was hard with tenderness and muscle guarding. Computed tomography scanning demonstrated a typical inhomogeneous target-shaped mass in the right abdomen. We diagnosed intussusception and performed emergency surgery. At laparotomy, ileocolic intussusception was observed and the ileocecal segment was resected. The surgical specimen comprised an 84 cm segment of resected ileocecum with an elongated polypoid lesion measuring 11 × 2 cm within the ileal lumen. Histopathological examination demonstrated that the polypoid lesion was an inverted Meckel diverticulum. Postoperatively, the patient made an uneventful recovery.

Keywords: Intussusception; Inverted diverticulum; Meckel diverticulum.

Fig. 1

CT scan demonstrated a typical inhomogeneous target-shaped mass in the right abdomen (arrow). The lead point was an intraluminal fatty mass measuring 2 cm, suggestive of intussusception caused by lipoma (arrowhead).

Fig. 2

The surgical specimen comprised an 84 cm segment of resected ileocecum with an elongated polypoid lesion (arrow) measuring 11 × 2 cm in diameter within the ileal lumen, and a lengthy segment of intestine was necrotic (arrowheads).

Fig. 3

Histopathological examination demonstrated an inverted diverticular wall with inner adipose tissue (arrowhead), muscular layer (arrow) (hematoxylin and eosin stain, viewed with a magnifying glass). b Ectopic gastric mucosa within the site marked by the rectangle in a (hematoxylin and eosin stain, magnification ×40).