Misdiagnosed Meckel's diverticulum with internal hernia mimicking appendicitis: A case report

Figure 1 Initial computed tomography examination. A: Absence of peritoneal fluid accumulation surrounding the liver (red arrow); B: Identification of an appendiceal fecalith with slight peri-appendiceal effusion (orange arrow); C: Dilation and fluid retention in a segment of the small intestine (green arrow).

Figure 2 Second computed tomography examination. A: Confirmation of the absence of fluid around the liver (red arrow); B: Marked dilation and increased wall thickness of the small intestine, increased from the initial presentation on admission (green arrow); C: Localized high-density area in the right lower quadrant suggesting potential hemorrhagic necrosis (yellow arrow).

Figure 3 Surgical photographs and photomicrograph. A: Visualization of localized necrosis in the intestinal loop after abdominal entry (red arrow); B: Intraperitoneal hernia noted after excision, along with evidence of intestinal obstruction (white arrow); C: Necrosis evident in conjunction with a Meckel's diverticulum (yellow arrow); D: Diverticulum presenting with prominent entrapment modifications (green arrow); E: Diverticulum ensnared in a configuration resembling a surgical knot (blue arrow); F: Postoperative histological examination revealed intestinal necrosis accompanied by inflammatory cell aggregation (hematoxylin-eosin staining, magnification 40 ×).