Divertículo de Meckel volvulado asociado a brida como causa de obstrucción en intestino delgado

Abstract

Introduction: Meckel’s diverticulum is the most frequent gastrointestinal anomaly. It’s more frequently seen in children less than 2 years of age. It´s caused by the incomplete obliteration of the omphalomesenteric conduct. Case report: 19 year old male patient with no previous medical history presents sudden onset of high intensity abdominal pain, initially located in the periumbilical region, radiating to right lower quadrant associated with emesis, fever and tachycardia. Physical examination showed abdominal guarding, rebound tenderness and decreased bowel sounds. During McBurney laparotomy a large volume of viscous free fluid was found and signs of small bowel obstruction, deciding close McBurney laparotomy and performing sub-umbilical midline laparotomy. Meckel diverticulum is founded, twisted and strangled, with a bridle adhesion to the mesenteric root, compromising the small bowel. The adherence and the MD are resected, obtaining appropriate peristaltic activity and color. Appendectomy and peritoneal lavage are performed without complications. Discussion: preoperatory diagnosis of MD is unfrequented and its need surgical exploration. MD’s volvulus is infrequent and in our case, intestinal obstruction it´s secondary to an adherence between the volvulated MD and the mesentery.