Title : Mesodiverticular band in meckel s diverticulum- A rare case of small bowel obstruction
Abstract:
Meckel’s diverticulum occurs in less than 3% of general population and is mostly asymptomatic.The most common complication due to Meckel’s diverticulum is intestinal obstruction followed by unexplained gastrointestinal bleeding, persistent abdominal pain or perforation. Complications mostly occur in male population and within 50 years of age. Here we present a case of a 72 year old lady who presented with a 24hour history of worsening abdominal pain, distension and vomiting. She underwent a CT scan which showed small bowel obstruction with a clear transition point in right iliac fossa but no obvious cause identified. She had a whipples resection 6 years ago with rooftop incision due to distal cholangiocarcinoma and had recovered from it. An emergency laparotomy revealed a band adhesion compressing the ileum and on relieving it, it was found to be a mesodiverticular band in meckles diverticulum causing the small bowel obstruction. 10cm of unhealthy bowel with the meckles diverticulum was resected and side to side anastomosis was performed. A mesodiverticular band is one that is attached to the diverticulum and ileal mesentery and directly compress the ileum. The diagnosis of Meckel's diverticulum as the cause of small bowel obstruction is often not made until the operation. CT scan, although being very accurate in identifying an obstruction,has poor sensitivity and specificity in detecting a mesodiverticular band.
Audience Take Away Notes:
- This is a rare case of small bowel obstruction due to a complication of meckel's diverticulum and should be taken into consideration as a cause of small bowel obstruction.
- A mesodiverticular band is one that is attached to the diverticulum and ilealmesentery and directly compress the ileum.
