Presentation
Acute diffuse abdominal pain, distension and vomiting.
Patient Data
Multiple air-fluid levels in dilated small bowel loops with a lack of normal gas distribution in the large bowel.
Abnormal dilation of the stomach, duodenum, jejunum and proximal small ileal loops till an abrupt change in caliber of the small bowel loop at the distal two-thirds of the ileum near the upper right quadrant. It is identified as a transitional zone with collapsed most distal ileal loops and large bowel. The right abdominal quadrant shows a converging distal ileal loop along its mesentery with congested prominent mesenteric vessels associated with small blind ending pouching with thick enhancing walls and surrounding fat stranding related to converging loops with associated small amount of peritoneal reflection free fluid.
The patient underwent surgery where inflamed Meckel's diverticulum with consequent small bowel obstruction.
Case Discussion
Intestinal obstruction is the second most common complication of Meckel's diverticulum. The mechanism of obstruction may due to trapping of the bowel loop by mesodiverticular band, extension into a hernial sac (Littre's hernia) or intussusception. Meckel's diverticulum is a true diverticulum also known as persistent omphalomesenteric duct hernias and is considered the most common structural congenital anomaly of the GIT.
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