A 70-year-old man seen for abdominal pain and diarrhea at the end of March 2000 was initially treated unsuccessfully with medication at the Department of Internal Medicine, then transferred to the Department of Emergency Medicine on March 31. Hematological examination showed an increased leukocyte count (12, 300/μ
l). Bowel obstruction was found in plain abdominal radiography. Abdominal computed tomography (CT) showed swelling of part of the small intestine. Based upon these findings, he was diagnosed with ileus and an ileus tube was inserted, after which he soon was free of pain and diarrhea, and his leukocyte count returned to normal. He was unable to have a bowel movement, however, and intestinal fluid from the ileus tube did not decrease. Radiography using contrast medium through the ileus tube showed absolute occlusion. We conducted surgery for intestinal stenosis on day 9 after admission. Laparotomy showed diverticulum of the ileum about 80 cm orally from the ileocecal valve. We partially excised the ileum, including the diverticulum. The protuberance of the intestine was pathologically confirmed to be Meckel's diverticulum. The ileal wall adjacent to the diverticulum was thickened due to inflammation, causing absolute occlusion of the internal lumen. No adhesion, strangulation, or distortion of the intestine and no malignant tumor were found. The cause of ileus in this case cannot be classified based on the Rutherford classification, so we diagnosed it as a rare case of ileus due to Meckel's diverticulum.
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