A CASE OF INTESTINAL OBSTRUCTION INDUCED BY TORSION OF MECKEL'S DIVERTICULUM IN AN ELDERLY PATIENT

Abstract

An 84-year-old man was seen at the hospital because of lower abdominal pain and vomiting. The patient was diagnosed with having intestinal obstruction by abdominal X-ray examination, and was admitted on the same day. Since conservative treatment was ineffective, an emergency laparotomy was performed on the 3rd hospital day. During surgery, a large diverticulum (8×7cm in diameter) was located in the ileum about 40cm proximal from the terminal ileum. The diverticulum was twisted clockwise by about 180 degrees, and the ileum was obstructed by flexion at the attachment of the diverticulum. The ileum was wedge-resected. Histologically, Meckel's diverticulum was diagnosed because the diverticulum contained normal ileal mucosa and serosa. No findings of ectopic gastric mucosa nor malignancy were seen. We rarely encounter reports of Meckel's diverticulum in elderly patients, but these patients are often associated with serious complications such as strangulated ileus and intussusception. Meckel's diverticulum must be kept in mind in elderly patients with intestinal obstruction of unknown origin.