Case Report
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World J Gastrointest Surg. Mar 27, 2014; 6(3): 47-50
Published online Mar 27, 2014. doi: 10.4240/wjgs.v6.i3.47
Giant Meckel’s diverticulum: An exceptional cause of intestinal obstruction
Sami Akbulut, Yusuf Yagmur
Sami Akbulut, Yusuf Yagmur, Department of Surgery, Diyarbakir Education and Research Hospital, Diyarbakir 21400, Turkey
Author contributions: Akbulut S and Yagmur Y designed, organized and wrote the report, and were attending doctors for the patients; Akbulut S performed surgical operation.
Correspondence to: Sami Akbulut, MD, FICS, FACS, Department of Surgery, Diyarbakir Education and Research Hospital, Uckuyular Mevki, Kayapinar, Diyarbakir 21400, Turkey. akbulutsami@gmail.com
Telephone: +90-412-2580075 Fax: +90-412-2580070
Received: November 19, 2013
Revised: January 5, 2014
Accepted: February 16, 2014
Published online: March 27, 2014
Abstract

Meckel’s diverticulum (MD) results from incomplete involution of the proximal portion of the vitelline (also known as the omphalomesenteric) duct during weeks 5-7 of foetal development. Although MD is the most commonly diagnosed congenital gastrointestinal anomaly, it is estimated to affect only 2% of the population worldwide. Most cases are asymptomatic, and diagnosis is often made following investigation of unexplained gastrointestinal bleeding, perforation, inflammation or obstruction that prompt clinic presentation. While MD range in size from 1-10 cm, cases of giant MD (≥ 5 cm) are relatively rare and associated with more severe forms of the complications, especially for obstruction. Herein, we report a case of giant MD with secondary small bowel obstruction in an adult male that was successfully managed by surgical resection and anastomosis created with endoscopic stapler device (80 mm, endo-GIA stapler). Patient was discharged on post-operative day 6 without any complications. Histopathologic examination indicated Meckel’s diverticulitis without gastric or pancreatic metaplasia.

Keywords: Meckel’s diverticulum, Giant Meckel’s diverticulum, Intestinal obstruction, Small bowel

Core tip: The most commonly diagnosed congenital anomaly of the gastrointestinal tract is Meckel’s diverticulum (MD), which occurs upon failure of the omphalomesenteric duct to regress and involute. MD can remain asymptomatic, and cases are generally diagnosed incidentally or upon investigation of unexplained gastrointestinal bleeding, perforation, inflammation, or obstruction for both paediatric and adult cases. It is estimated that as little as 4% of cases manifest complications, and obstruction is the most common presenting symptom in adults. In this case study, we report a case of giant MD with secondary small bowel obstruction in an adult male that was successfully managed by surgical resection and anastomosis created with endoscopic stapler.