Meckel's diverticulitis causing small bowel obstruction by a novel mechanism

Abstract

Meckel's diverticulum occurs in 2% of the general population and majority of patients remain asymptomatic. Gastrointestinal bleeding is the most common presentation in the paediatric population. While asymptomatic and incidentally found Meckel's diverticulum may be left alone, surgery is essential for treating a symptomatic patient. Despite advances in imaging and technology, pre-operative diagnosis is often difficult. We present a first report of an unusual mechanism of small bowel obstruction due to Meckel's diverticulitis in a paediatric patient. The diagnosis was only apparent at laparotomy.

Keywords: Meckel’s diverticulitis; Meckel’s diverticulum; small bowel obstruction..

Figure 1

Computed tomography scan showing dilated small bowel loops and mucosal oedema. The bowel wall is well enhancing.

Figure 2

Computed tomography scan showing worsening small bowel dilatation and a transition point (green arrow) at the ileum.

Figure 3

Intra-operative photograph showing normal appendix and gangrenous Meckel’s diverticulum. Miniature photograph of resected specimen.