A Case of Meckel's Diverticulitis with Intestinal Malrotation Diagnosed Preoperatively and Treated Surgically

Abstract

A 20-year-old man who presented to our emergency department because of right flank pain was diagnosed with acute appendicitis and was referred to our surgery section. An abdominal contrast-enhanced computed tomography showed edema of the small intestine in the right lateral region of abdomen, and a blinded lumen extending toward the umbilicus from there. The ascending colon and ileocecal region were located in the midline of the abdomen, while the small intestine was observed on the right side of the colon.

Therefore, we diagnosed this case as Meckel's diverticulitis with intestinal malrotation and performed an emergency surgery. Intra-operatively, a Meckel's diverticulum was observed 65 cm from the end of ileum, and partial ileal resection and appendectomy were performed. Histopathological examination revealed fundic gland-type gastric mucosa and ectopic pancreas with inflammatory changes in the diverticulum. Although Meckel's diverticulitis with intestinal malrotation is rare, we report a case in which multidetector row CT (MDCT) scanning was useful for preoperative diagnosis, together with some bibliographical comments.