Case report: Diverticulitis complicating a giant Meckel’s divertuculum

• Published in: International journal of surgery case reports Vol. 65; pp. 209 - 212
• Main Authors: García-Quijada García, Javier, Bustamante Recuenco, Carlos, Carabias Hernández, Alberto, Valle Rubio, Ainhoa
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.01.2019; Elsevier
• Subjects: Abdomino-pelvic CT; Adult; Diverticulum; Giant; Intestinal resection; Meckel; Abdomino-pelvic CT; Diverticulum; Adult; Intestinal resection; Meckel; Giant
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2019.10.074

•Meckel’s diverticulitis is a rare condition which may need surgical approach.•It is uncommon that Meckel’s diverticulum causes symptomatic disease in adults.•Although early detection is often challenging, an abdominal CT-scan may establish a certain diagnosis in giant diverticula.•Emergency surgery is mandatory in patients with complicated Meckel’s diverticulum.•Segmental resection is the approach of choice when a giant diverticulum has inflammatory signs. In this paper, we discuss a unique case of diverticulitis in which the patient presented a giant Meckel’s diverticulum. The patient was a 44 year old male whose medical history included a laparoscopic gastric bypass four years before the finding, and chronical high blood pressure. The patient came to the emergency department with an abdominal pain and elevated acute-phase reactants. An abdominal CT revealed a 17 cm long Meckel’s diverticulum with signs of severe inflammation. The patient was then taken to the operating room, and subjected to a 4 cm ileum resection, including the entire diverticulum, with a manual end-to-end anastomosis. Although Meckel’s diverticulum is the most common congenital abnormality of the intestinal tract, it is unusual for it to cause symptoms in adults. However, when a patient arrives at the emergency department with a complicated Meckel’s diverticulum, an early diagnosis is essential to prevent serious complications, such as perforation of the diverticulum and subsequent peritonitis. The presence of a giant diverticulum is an extremely rare condition. There are few publications to date, but these diverticula are associated with more complications, presenting a higher risk of torsion, volvulus or intestinal obstruction. This paper include a bibliographic review of existing studies on etiopathogenesis, and the diagnosis and treatment of complicated Meckel’s diverticulum, particularly in its giant variant. Although Meckel’s diverticulitis is a rare entity, it can appear as an acute abdomen. An early diagnosis and treatment to prevent subsequent complications is essential to ensure an optimal recovery.