An Unknown Complication of a Rare Combination of Intestinal Invagination and Meckel’s Diverticulum Invaginated in An Adult: A Case Report

Abstract

Introduction: Intestinal invagination is a common pathology amongst children, while it is a rare entity in adults. Invagination is responsible for only 1-3% of adult-onset intestinal obstruction. Meckel’s diverticulum, on the other hand, is the most common congenital anomaly of the gastrointestinal tract. Most of them are asymptomatic; they are recognized when they complicate, and can present with diverticulitis, gastrointestinal bleeding, intestinal obstruction, perforation, or invagination. Invagination with the Meckel’s diverticulum (MD) is a rare cause of chronic abdominal pain in the adults. We wish to present this first case of intestinal invagination and Meckel ‘s diverticulum invaginated. Presentation of case: We report the case of a 17-year-old man who was admitted to the emergency room due to a diffuse abdominal pain. Abdominal CT scan showed intestinal invagination and intestinal obstruction. The exploratory laparoscopy revealed the presence of intestinal invagination and segmental resection of the small intestine was performed. The patient was discharged on the sixteen post-operative day. Discussion: The prevalence of MD is 1 to 4%. Diagnosis is often difficult and delayed because clinical symptoms are not specific and the diagnosis is performed mainly by imaging studies. Intestinal obstruction is a more common complication in adults, whereas in children, bleeding is the more common complication. In our case, the patient had a diffuse abdominal pain with small bowel obstruction. Laparoscopy may be useful for confirming the presence of intestinal invagination, and demonstrating the underlying organic lesion serving as the lead point. Only with the laparotomy we have been able to notice the combination of intestinal invagination and MD invaginated. Conclusion: we aimed to present the role of Meckel’s diverticulum as an initiating factor of illegible invagination, with inversion into the ileum and specifically in our clinical case can cause invagination of itself.