Intestinal Obstruction Due to Necrotic Torsion of a Meckel’s Diverticulum: A Case Report in a Young Adult

¹K. Kamal, ²M. Mountassir, ³H. EL Rharchi, ⁴A. Majd, ⁵A. Ettaoussi, ⁶M. Bouali, ⁷A. El Bakouri, ⁸K. El Hattabi

^{1,2,3,4,5,6,7,8}Department of general surgery, Emergency Visceral Surgery Unit 35, IBN ROCHD University hospital of Casablanca, Casablanca, Morocco

DOI: 10.58806/ijhmr.2025.v4i8n09

ABSTRACT

Meckel’s diverticulum is recognized as the most prevalent congenital anomaly of the gastrointestinal system. While frequently asymptomatic, it can occasionally result in serious complications such as gastrointestinal hemorrhage, diverticulitis, or bowel obstruction. We present the case of a 20-year-old male who developed acute small bowel obstruction, initially resembling mesocoeliac appendicitis. Surgical intervention revealed a necrotic Meckel’s diverticulum twisted around a viable loop of ileum, creating an internal constrictive band and causing the obstruction. Treatment included segmental resection of the diverticulum, a double-barrel ileostomy, and peritoneal lavage. This case underscores the need to consider Meckel’s diverticulum as a differential diagnosis in intestinal obstruction, particularly among young adults with no prior abdominal surgeries.

KEYWORDS

Meckel’s diverticulum, vitelline duct remnant, small bowel obstruction, exploratory laparotomy.

REFERENCES

1) Sagar J, Kumar V, Shah DK. Meckel’s diverticulum: a systematic review. J R Soc Med. 2006;99(10):501–505.
2) Park JJ, Wolff BG, Tollefson MK, et al. Meckel diverticulum: the Mayo Clinic experience with 1476 patients (1950-2002). Ann Surg. 2005;241(3):529–533.
3) Dumper J, Mackenzie S, Mitchell P, et al. Complications of Meckel’s diverticula in adults. Can J Surg. 2006;49(5):353–357.
4) Leijonmarck CE, Bonman-Sandelin K, Frisell J. Meckel’s diverticulum in the adult. Br J Surg. 1986;73(2):146–149.
5) Soltero MJ, Bill AH. The natural history of Meckel’s diverticulum and its relation to incidental removal. Am J Surg. 1976;132(2):168–170.
6) Hansen CC, Søreide K. Systematic review of emergency presentations and surgical outcomes in Meckel’s diverticulum. World J Gastrointest Surg. 2020;12(9):393–403.