Journal of Medical Sciences and Health Care Research
Meckelâs Diverticulum Which Suicide Itself and Sacrificing Part of Ileum Due to Diverticular Band â A Case Report
Abstract
Mezgebu Bogale
Introduction Meckel’s diverticulum is the most common form of gastrointestinal congenital anomaly. It’s common complication being inflammation, bleeding, perforation, and obstruction. It is well known that the commonest complication is obstruction, but gangrenous meckel’s diverticulum is rarest. Due to various reasons preoperative diagnosis is challenging. Our case was diagnosed being delayed. Since gangrene formation is rare, here I presented a case with gangrenous meckel’s diverticular band forming closed loop gangrenous small bowel obstruction for academic interest.
Case Presentation This patient was 29-years-old female patient presented with central abdominal pain of 2 days duration. She has also diarrhea and vomiting of ingested matter not more than three episodes. She has history of dyspepsia. On physical examination vital signs were in acceptable range. Mild epigastric tenderness was there. In addition, radiologic results were unremarkable except minimal pelvic fluid in sonographic evaluation. For the above vague findings she was put on antacid medications and the decision for surgery was delayed for 24hrs. But her symptoms worsened and exploratory laparotomy done; found to have 1L haemorregic fluid, 150cm gangrenous ileum and gangrenous diverticulum which has arisen 1m away from ileocecal valve. We did resection of gangrenous part and ileo-transverse anastomosis done because; the remaining distal ileum was ultra-short to do end to end anastomosis. The out- come was uneventful.
Discussion Diagnosing meckel’s diverticulum complication is challenging due to non-specific clinical manifestation, less specificity & sensitivity of laboratory tests and radiologic findings. It is wise to consider meckel’s diverticulum and its complications in the arena of acute abdomen both as a surgeon and radiologist hence prompt management leading to decreased morbidity and mortality.
Conclusion Though diverticulum causing gangrene of itself and small bowel is rare, it is good to have high index of suspicion as a surgeon and radiologist