Axial Torsion of Meckel's Diverticulum Causing Small Bowel Obstruction in Adult: A Case Report

Abstract

Meckel’s diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract that occurs in 2–3% of the population (1). The MD results from incomplete obliteration of the proximal most portion of the omphalomesenteric duct within 5 to 7 weeks of fetal development (2). Gastrointestinal bleeding due to ectopic gastric mucosa of MD causing ileal peptic ulceration is the most common complication in childhood. In adults, the more common complication is bowel obstruction caused by either intussusception or small bowel volvulus around a fibrotic band or patent omphalomesenteric duct anchored to the anterior abdominal wall. Other common complications include acute inflammation leading to perforation and hemorrhage. More rare complications include perforation of MD with foreign bodies, vesicodiverticular fistulae, strangulation in Littre’s hernia, or primary neoplasms. Torsion of MD, one of the rarest complications, is the result of axial twisting around its base (3). Pre-operative diagnosis of MD as a cause of small bowel obstruction is difficult, because the diagnosis can be made only if the diverticulum is delineated at the site of obstruction. In many cases, computed tomography (CT) features are similar to those of small bowel obstruction secondary to postoperative adhesions. Imaging features and risk factors of small bowel obstruction secondary to MD suggest the diagnosis. Herein, we reported a rare case of MD with axial torsion; furthermore, we briefly reviewed the relevant literature. Axial Torsion of Meckel’s Diverticulum Causing Small Bowel Obstruction in Adult: A Case Report 성인에서 발생한 멕켈 게실의 급성 염전에 의한 소장 폐색: 증례 보고