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Unusual Presentation of Meckel's Diverticulum: Gangrene due to Axial Torsion.

Rencuzogullari A, Dalci K, Yalav O - Case Rep Emerg Med (2015)

Bottom Line: Meckel's diverticulum is the most common congenital anomaly of the small bowel.The majority of cases are asymptomatic; however, life-threatening complications can also take place.We present a case of a 37-year-old male who was admitted with symptoms of acute, severe abdominal pain in the right iliac fossa.

View Article: PubMed Central - PubMed

Affiliation: Department of General Surgery, Cukurova University Medical Faculty, 01330 Adana, Turkey.

ABSTRACT
Meckel's diverticulum is the most common congenital anomaly of the small bowel. The majority of cases are asymptomatic; however, life-threatening complications can also take place. We present a case of a 37-year-old male who was admitted with symptoms of acute, severe abdominal pain in the right iliac fossa. The patient was operated on with the preoperative diagnosis of acute appendicitis but the operative findings were consistent with torted Meckel's diverticulum due to presence of mesodiverticular band and he was treated successfully with surgical resection.

No MeSH data available.


Related in: MedlinePlus

(a) Transmural necrosis and hemorrhage (H&E staining ×100 magnification). (b) Ischemic necrosis, congestion, and hemorrhage (H&E staining ×100 magnification).
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fig2: (a) Transmural necrosis and hemorrhage (H&E staining ×100 magnification). (b) Ischemic necrosis, congestion, and hemorrhage (H&E staining ×100 magnification).

Mentions: A 37-year-old man presented to our hospital with an 8-hour history of acute, severe, and right lower abdominal pain. The physical examination of patient revealed defense and guarding in the right lower quadrant, with rebound tenderness and altered bowel sounds. The leukocyte count was elevated at 13.7 × 109/L, and a differential count demonstrated 90% segmented neutrophils. An abdominal X-ray showed minimally dilated small bowel loops. The patient was operated on with the preoperative diagnosis of acute appendicitis. The appendix, however, intraoperatively was normal; thus, the incision was extended. The torted MD was observed 60 cm proximal to the ileocecal valve and had distal necrosis (Figure 1). The rest of the bowel appeared normal. MD was resected by using a stapling device. Pathological examination confirmed the diagnosis of MD with gangrene (Figures 2(a) and 2(b)). The recovery period was uncomplicated and the patient was discharged on postoperative day 5.


Unusual Presentation of Meckel's Diverticulum: Gangrene due to Axial Torsion.

Rencuzogullari A, Dalci K, Yalav O - Case Rep Emerg Med (2015)

(a) Transmural necrosis and hemorrhage (H&E staining ×100 magnification). (b) Ischemic necrosis, congestion, and hemorrhage (H&E staining ×100 magnification).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4352490&req=5

fig2: (a) Transmural necrosis and hemorrhage (H&E staining ×100 magnification). (b) Ischemic necrosis, congestion, and hemorrhage (H&E staining ×100 magnification).
Mentions: A 37-year-old man presented to our hospital with an 8-hour history of acute, severe, and right lower abdominal pain. The physical examination of patient revealed defense and guarding in the right lower quadrant, with rebound tenderness and altered bowel sounds. The leukocyte count was elevated at 13.7 × 109/L, and a differential count demonstrated 90% segmented neutrophils. An abdominal X-ray showed minimally dilated small bowel loops. The patient was operated on with the preoperative diagnosis of acute appendicitis. The appendix, however, intraoperatively was normal; thus, the incision was extended. The torted MD was observed 60 cm proximal to the ileocecal valve and had distal necrosis (Figure 1). The rest of the bowel appeared normal. MD was resected by using a stapling device. Pathological examination confirmed the diagnosis of MD with gangrene (Figures 2(a) and 2(b)). The recovery period was uncomplicated and the patient was discharged on postoperative day 5.

Bottom Line: Meckel's diverticulum is the most common congenital anomaly of the small bowel.The majority of cases are asymptomatic; however, life-threatening complications can also take place.We present a case of a 37-year-old male who was admitted with symptoms of acute, severe abdominal pain in the right iliac fossa.

View Article: PubMed Central - PubMed

Affiliation: Department of General Surgery, Cukurova University Medical Faculty, 01330 Adana, Turkey.

ABSTRACT
Meckel's diverticulum is the most common congenital anomaly of the small bowel. The majority of cases are asymptomatic; however, life-threatening complications can also take place. We present a case of a 37-year-old male who was admitted with symptoms of acute, severe abdominal pain in the right iliac fossa. The patient was operated on with the preoperative diagnosis of acute appendicitis but the operative findings were consistent with torted Meckel's diverticulum due to presence of mesodiverticular band and he was treated successfully with surgical resection.

No MeSH data available.


Related in: MedlinePlus