Abstract:

Meckel’s diverticulum is the most common congenital anomaly of the gastrointestinal tract. In this article, a case with meckel’s diverticulum including ectopic pancreas and gastric tissue causing intestinal obstruction due to rotation of its own axis is presented. Forty-six years old male patient, with ongoing abdominal pain, nausea, vomiting, inability to pass gas and stool for 3 days was admitted to our emergency department. On physical examination the patient had rigidity, tenderness and rebound especially in the right lower quadrant of the abdomen. Abdominal x-ray revealed multiple air-fluid levels on small intestine. In surgical exploration, intestinal obstruction due to axial torsion of meckel’s diverticulum was seen. After detorsion, the partial small bowel resection with diverticulectomy and end to end anastomosis was performed because the distal segment of the small intestine was narrowed with a fibrotic constriction. Axial torsion is a rare complication of meckel’s diverticulum. Preoperative diagnosis of meckel’s diverticulum and its complications are extremely difficult which often requiring emergent surgical invention (ileus, perforation…). The preferred surgical treatment of broad-based diverticula is usually segmental resection of the involved segments and for narrow-based diverticula the surgical option is usually diverticulectomy. Eventually, meckel's diverticulum and its complications should be taken into consideration, in patients with mechanical intestinal obstruction and / or acute abdomen.

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