Acute small bowel obstruction as a result of a Meckels diverticulum encircling the terminal ileum: A case reportReport as inadecuate

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Journal of Medical Case Reports

, 1:8

First Online: 23 March 2007Received: 22 December 2006Accepted: 23 March 2007DOI: 10.1186-1752-1947-1-8

Cite this article as: Thakor, A.S., Liau, S.S. & o-Riordan, D.C. J Med Case Reports 2007 1: 8. doi:10.1186-1752-1947-1-8


BackgroundIn the developed world, small bowel obstruction accounts for 20% of all acute surgical admissions. The aetiology for majority of these cases includes postoperative adhesions and herniae. However, a relatively uncommon cause is a Meckel-s diverticulum. Although this diagnosis is primarily reported in the adolescent population, it should also be considered in adults.

Case PresentationIn the present report, we present a rare case where a fit and healthy 74-year-old gentleman, with no previous history of abdominal surgery, presented with the cardinal symptoms and signs of small bowel obstruction as the result of a Meckel-s diverticulum encircling his terminal ileum. Initial investigations included a supine abdominal x-ray showing dilated loops of small bowel and computerised tomographic imaging of the abdomen, which revealed a stricture in the terminal ileum of unknown aetiology. At laparotomy, multiple loops of distended small bowel were seen from the duodeno-jeujenal junction to the terminal ileum, which was encircled by a Meckel-s diverticulum. The Meckel-s diverticulum was then divided to release the obstruction, mobilised and subsequently removed. Finally, the small bowel contents were decompressed into the stomach and the nasogastric tube aspirated, before returning the loops of bowel into the abdomen in sequence. The patient made a good postoperative recovery and was discharged home 5 days later.

ConclusionThis report highlights the importance of considering a Meckel-s diverticulum as a cause of small bowel obstruction in individuals from all age groups and especially in a person with no previous abdominal pathology or surgery.

Electronic supplementary materialThe online version of this article doi:10.1186-1752-1947-1-8 contains supplementary material, which is available to authorized users.

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Author: Avnesh S Thakor - Siong S Liau - Dermot C o-Riordan


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