A Case of Strangulated Ileus With Torsion of the Neck of Meckel’s Diverticulum

Abstract

The patient was a 15-year-old boy. He consulted a previous physician for the chief complaint of abdominal pain that started at midnight and was referred to our hospital with a diagnosis of generalized peritonitis. Physical examination showed peritoneal irritation, and abdominal CT showed a strangulated ileus with a closed loop forming ascites. Emergency operation was performed under the diagnosis of strangulated ileus due to Meckel’s diverticulum pedicle torsion. Laparoscopic observation under a general umbilical longitudinal incision under general anesthesia revealed a Meckel’s diverticulum about 50 mm from the ileocecal region, the tip of the diverticulum adhered to the mesentery, and the diverticulum itself formed a band. The stem turned 360 degrees and became dark red. When the band was dissected, the color of the strangulated intestinal tract improved and no bowel resection was performed, and a wedge resection of Meckel’s diverticulum was carried out. His postoperative course was good and he was discharged on postoperative day 10. It is considered important to keep in mind the involvement of Meckel’s diverticulum in the diagnosis and treatment of ileus in children without a history of laparotomy. We here report a rare case of strangulated ileus associated with Meckel’s diverticulum pedicle torsion.