A Case of Meckel's Diverticulum Torsion Causing Ileus

Abstract

A 8-year-old boy was referred to our hospital with abdominal pain and vomiting. As he was diagnosed as having enterocolitis, he was admitted to our hospital and received conservative treatment. The next day, physical examinations revealed progressive abdominal tenderness with muscle guarding and rebound tenderness. Computed tomography scan revealed a dilated small intestine and a fluid-filled cystic lesion with air in the right lower quadrant. An emergency laparotomy was performed with a suspected strangulation ileus. A Meckel's diverticulum, 10cm×2.5cm in size, was found on the ileum about 80cm proximal to the Bauhin's valve. It was twisted about 180° counterclockwise at its neck and was necrotized. A diverticulectomy was performed. No postoperative complications occurred and the patient was discharged on the 8th day after the operation. Torsion is a rare complication of Meckel’s diverticulum in childhood, and we found reports of only 11 cases in Japan. Those diverticula were also large, greater than 6cm in length, and had narrow necks. In our case, we thought that the ileus was the result of torsion of Meckel's diverticulum, associated with peritoneal inflammation.