Case report: laparotomy for intestinal obstruction with volvulus due to torsion of Meckels diverticulum
Lisa Ellegård, Sara Persson, Roger OlénAbstract
Introduction
The aim of this case report is to highlight a rare complication of a common congenital anomaly of the gastrointestinal tract.
Methods
A 21-month-old previously healthy full-term boy with no prior surgery presented with symptoms of intestinal obstruction, with intermittent abdominal pain and vomiting for 3 days. The x-ray showed dilated intestines, presumably an upper gastrointestinal obstruction. Ultrasound showed no signs of intussusception. The patient underwent exploratory laparotomy, revealing heavily dilated intestines. There were no signs of necrosis. At first, the location of the intestines gave the impression of malrotation. Colon was not in its right position, with appendix in the upper left quadrant. We then found a solid tumour with a narrow base located outside of the small intestine, at 150 cm from the ileocecal valve. The tumour extended into an adhesion band, responsible for the volvulus. After cutting the adhesion band, the anatomy was restored. The part of the intestine with the tumour was resected. The postoperative course was uneventful, with discharge on day 5.
Results
Histopathological examination revealed a necrotized Meckel's diverticulum.
Discussion
Meckel's diverticulum is a common congenital anomaly of the gastrointestinal tract with a variety of presentations. It is often asymptomatic, sometimes presenting with typical symptoms and rarely presenting as torsion of the diverticulum with volvulus.