Case Report
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World J Gastrointest Surg. Jul 27, 2011; 3(7): 106-109
Published online Jul 27, 2011. doi: 10.4240/wjgs.v3.i7.106
Intestinal obstruction caused by torsed gangrenous Meckel’s diverticulum encircling terminal ileum
Carmine Cartanese, Tommaso Petitti, Ernesto Marinelli, Antonio Pignatelli, Davide Martignetti, Matteo Zuccarino, Lucio Ferrozzi
Carmine Cartanese, Tommaso Petitti, Ernesto Marinelli, Antonio Pignatelli, Davide Martignetti, Matteo Zuccarino, Lucio Ferrozzi, Department of General Surgery, Masselli-Mascia Hospital, 71016 San Severo, Italy
Author contributions: All authors contributed to the intellectual content and approved the final version; Cartanese C, Petitti T and Zuccarino M designed the study; Cartanese C, Pignatelli A, Marinelli E and Martignetti D performed the research; Ferrozzi L analyzed the data; Cartanese C wrote the paper.
Correspondence to: Cartanese Carmine, MD, Department of General Surgery, Masselli-Mascia Hospital, Via T. Masselli, 28, 71016 San Severo, Italy. carminecartanese@libero.it
Telephone: +39-882-200271 Fax: +39-882-200428
Received: February 17, 2011
Revised: June 16, 2011
Accepted: June 24, 2011
Published online: July 27, 2011
Abstract

Meckel’s diverticulum (MD) is considered the most prevalent congenital anomaly of the gastrointestinal tract. It may result in a number of complications including hemorrhage, obstruction, and inflammation. Obstruction of various types is the most common presenting symptom in the adult population. Loop formations with the end of an MD and adjacent mesentery constricting the distal ileum is an uncommon cause of obstruction. Axial torsion and gangrene of MD is the rarest of the complications. The correct diagnosis of complicated MD before surgery is often difficult because this condition may mimic other acute abdominal pathologies. Delay in the diagnosis of a complicated MD can lead to significant morbidity and mortality. Here we describe the case of a patient with a very rare form of acute small bowel obstruction secondary to giant torsed gangrenous MD encircling the terminal ileum. To our knowledge, this co-occurrence of axial torsion and a loop-forming mechanism of obstruction has been reported only once in English medical literature.

Keywords: Meckel’s diverticulum, Axial torsion, Gangrene, Intestinal obstruction, Mesodiverticular band