Abstract
Meckel’s diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract. Its course is usually benign but may also result in complications requiring surgical intervention. A diverticulum may also permit the removal of intraluminal objects without bowel resection and anastomosis.A woman in her 50s was found to have a mechanical small bowel obstruction secondary to an intraluminal mass within the terminal ileum. On exploration, an MD was encountered proximal to the mass. A diverticulectomy was performed after maneuvering the enterolith into the diverticulum.Meckel’s diverticulum with an associated enterolith is a rare cause of small bowel obstruction. Historic imaging may show long-standing stones in the bowel lumen and provide a diagnostic clue. Diverticulectomy may be performed to reduce the risks of small bowel resection and anastomosis. This technique can be used for other intraluminal objects requiring removal in the presence of an MD.
Highlights
Meckel’s diverticulum (MD) is caused by the incomplete obliteration of the vitelline duct during the seventh to eighth week of gestation [1]
We present a case report and literature review of a small bowel obstruction caused by an enterolith formed within an MD
The patient is a woman in her 50s who presented to the emergency department (ED) with a two-day history of colicky abdominal pain in the mid-epigastrium and right lower quadrant associated with nausea, emesis, distention, and obstipation
Summary
Meckel’s diverticulum (MD) is caused by the incomplete obliteration of the vitelline duct during the seventh to eighth week of gestation [1]. The patient is a woman in her 50s who presented to the emergency department (ED) with a two-day history of colicky abdominal pain in the mid-epigastrium and right lower quadrant associated with nausea, emesis, distention, and obstipation She had a past medical history of hypertension and major depressive disorder treated with losartan and citalopram, respectively; and regarding her surgical history, she did not have any prior abdominal operation. Serum electrolytes were indicative of mild volume depletion She subsequently underwent a CT scan of the abdomen and pelvis which showed a distal small bowel obstruction with a transition point at a 2.9 cm round intraluminal structure with central calcification (Figure 1B). The patient is currently alive and well and, as recurrence is unlikely status post diverticulectomy, she has been surgically dismissed
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