A Case Report of Torsion of Meckel’s Diverticulum

Abstract

The incidence of symptomatic Meckelʼs diverticulum is rare, particularly that of diverticular torsion is as low as 3.2％. Here we report a case of torsion of Meckelʼs diverticulum of the intestinal neck after an internal hernia because of a mesodiverticular band. A 19-year-old female was admitted with abdominal pain. Enhanced abdominal CT revealed a tumor with poor contrast effect in the right lower quadrant. Accordingly, we suspected an internal hernia or ileum obstruction. Follow-up CT after 8 h revealed an increase in ascites and attenuation of contrast effect. We performed an urgent laparoscopy because a strangulated ileum obstruction was observed. We found blood flow disturbance in the small intestine because of which we had to perform laparotomy. The tumor was an ileum diverticulum, with a cord between the mesenterium and diverticulum. The diverticulum had become necrotic because of 360° torsion with the neck. Finally, we diagnosed the ileum obstruction as a 360° torsion of Meckelʼs diverticulum, twisted by a mesodiverticular band. Axial torsion of Meckelʼs diverticulum by MDB is rare. In our case, it seemed that the preoperative diagnosis was feasible because preoperative CT findings exhibited Meckel diverticulum and MDB.