Meckel′s diverticulum in a man with undescended testis presenting as abdominal emergency

Abstract

Even though Meckel's diverticulum is the most common anomaly of the gastrointestinal tract, it is asymptomatic in the majority of cases. With life time complication rate of 4%, it is an uncommon cause of intestinal obstruction in adult. We report a case of Meckel's diverticulum attached to undescended testis presenting as acute abdomen in an adult with intestinal obstruction. The patient a 36-year-old man presented with acute abdominal pain, vomiting and distension. On examination, there was distension of the abdomen with tenderness and guarding rigidity and absence of testis in right scrotum. Erect X-ray of abdomen showed multiple air fluid levels suggestive of intestinal obstruction. A diagnosis of acute intestinal obstruction was made and the patient was resuscitated and taken to the operation theater after adequate hydration and antibiotic cover. On exploration, it was found that Meckel's diverticulum attached to undescended testis with diverticular band forming an entangled mass, which caused complete obstruction of the bowel. It was treated successfully with resection of diverticulum and the band followed by a bowel anastomoses and orchidectomy. We conclude that it is indeed rare for two different congenital anomalies coexisting together to cause intestinal obstruction in an adult patient. High clinical suspicion is required to diagnose such rare congenital abnormality which if followed promptly by surgical intervention would lead to a satisfactory outcome.