A Case of Torsion of Meckel’s Diverticulum with Strangulated Small Bowel Obstruction Caused by a Mesodiverticular Band

Abstract

A 9-year-old boy was brought to our hospital with a day’s history of abdominal pain. Contrast-enhanced computed tomography revealed strangulated small bowel obstruction with poor contrast enhancement of a segment of the intestine, as well as of a blind-end structure that was suspected as the Meckel’s diverticulum; a mesodiverticular band was found attached to the diverticulum. Intraoperatively, the strangulated small bowel segment was found to be adjacent to the mesodiverticular band and the Meckel’s diverticulum was included in the strangulating band, with torsion. Since the ischemia did not improve even after release of the torsion and strangulation, we performed partial resection of an approximately 5-cm segment of the small bowel. The postoperative course was good and the patient was discharged on postoperative day 7. Simultaneous occurrence of torsion of the diverticulum and strangulation of the small bowel by a mesodiverticular band is rare. Meckel’s diverticulum may be dependent on the MB for its blood flow. Therefore, partial small bowel resection rather than a wedge resection in the case of Meckel’s diverticulum with mesodiverticular band may help improve the prognosis.