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Persistence of a vitelline artery on a Meckel’s diverticulum as a cause of bowel infarction

  • Mauricio Gonzalez-UrquijoEmail author
  • Matilde Espino-Rodriguez
  • Andrea Romero-Davila
  • Mario Rodarte-Shade
  • Ger ardo Gil-Galindo
Case Report
  • 14 Downloads

Abstract

Meckel’s diverticulum is a congenital anomaly, resulting from incomplete obliteration of the most proximal portion of the omphalomesenteric duct. It generally remains silent, but life-threatening complications may arise in 4–6% of the patients. We present a case of a 16-year-old male, who arrived at the emergency room with crampy abdominal pain, nausea, and vomiting, suggestive of acute appendicitis. Surgical exploration revealed 150 cm of infarcted small bowel, secondary to a mesodiverticular band of a Meckel’s diverticulum at the site of obstruction. The ischemic small bowel with Meckel’s diverticulum was resected, and an ileo-ileal anastomosis was carried out. The postoperative course was uneventful, and the patient was discharged on the fifth postoperative day. He was seen 12 months after his initial surgery, with a favorable outcome.

Keywords

Meckel’s diverticulum Mesodiverticular band Bowel obstruction Bowel ischemia 

Notes

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Compliance with ethical standards

Conflicts of interest

The authors declare that they have no conflict of interest.

Human rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of Tecnologico de Monterrey ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed consent

Written informed consent was obtained from the patient for publication of this case report and accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal on request.

References

  1. 1.
    Murruste M. Torsion of Meckel’s diverticulum as a cause of small bowel obstruction: a case report. World J Gastrointest Surg. 2014;6(10):204.CrossRefGoogle Scholar
  2. 2.
    You JS, Chung SP, Park YS, Yu JS, Park YA. A case of strangulated small bowel obstruction caused by Meckel’s diverticulum in an adult. J Emerg Med. 2007;33(2):133–5.CrossRefGoogle Scholar
  3. 3.
    Prall RT, Bannon MP, Bharucha AE. Meckel’s diverticulum causing intestinal obstruction. Am J Gastroenterol. 2001;96(12):3426–7.CrossRefGoogle Scholar
  4. 4.
    Kuru S, Bulus H, Kismet K, Aydin A, Yavuz A, Tantoglu U. Mesodiverticular band of Meckel’s diverticulum as a rare cause of small bowel obstruction: case report and review of the literature. Visc Med. 2013;29(6):401–5.CrossRefGoogle Scholar
  5. 5.
    Sagar J, Kumar V, Shah DK. Meckel’s diverticulum: a systematic review. J R Soc Med. 2006;99(10):501–5.CrossRefGoogle Scholar
  6. 6.
    Kiyak G, Ergul E, Sarikaya SM, Kusdemir A. Axial torsion and gangrene of a giant Meckel’s diverticulum mimicking acute appendicitis. J Pak Med Assoc. 2009;59(6):408–19.PubMedGoogle Scholar
  7. 7.
    Manning VR, McLaughlin EF. Persistent omphalomesenteric (Vitelline) artery causing intestinal obstruction and gangrene of meckel’s diverticulum. Ann Surg. 1947;126(3):358–65.CrossRefGoogle Scholar
  8. 8.
    Pansky B. Embriologia medic. Editorial Médica Panamericana; 1985.Google Scholar
  9. 9.
    Sharma RK, Jain VK. Emergency surgery for Meckel’s diverticulum. World J Emerg Surg. 2008;3(1):1–8.CrossRefGoogle Scholar
  10. 10.
    Farooq M, Rajesh A. Giant Meckel’s diverticulum compressing root of mesentery—a rare cause of ileal gangrene—case report and review of literature. Int J Surg Case Rep. 2017;38(3):53–6.  https://doi.org/10.1016/j.ijscr.2017.06.063 CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Malhotra S, Roth DA, Gouge TH, Hofstetter SR, Sidhu G, Newman E. Gangrene of Meckel’s diverticulum secondary to axial torsion: a rare complication. Am J Gastroenterol. 1998;93(8):1373–5.CrossRefGoogle Scholar
  12. 12.
    Murakami R, Sugizaki K, Kobayashi Y, Ogura J, Yamamoto K, Kurokawa A et al. Strangulation of small bowel due to Meckel diverticulum: CT findings. Clin Imaging. 1999;23(3):181–3.CrossRefGoogle Scholar
  13. 13.
    Farris S, Fernbach SK. Axial torsion of Meckel’s diverticulum presenting as a pelvic mass. Pediatr Radiol. 2001;31(12):886–8.CrossRefGoogle Scholar
  14. 14.
    Eser M, Oncel M, Kurt N. Gangrene secondary to axial torsion in a patient with Meckel’s diverticulum. Int Surg. 2002;87(2):104–6.PubMedGoogle Scholar
  15. 15.
    Tan Y-M, Zheng Z-X. Recurrent torsion of a giant Meckel’s diverticulum. Dig Dis Sci. 2005;50(7):1285–7.CrossRefGoogle Scholar
  16. 16.
    Limas C, Seretis K, Soultanidis C, Anagnostoulis S. Axial torsion and gangrene of a giant Meckel’s diverticulum. J Gastrointestin Liver Dis. 2006;15(1):67–8.PubMedGoogle Scholar
  17. 17.
    Sharma RK, Jain VK, Kamboj S, Murari K. Gangrenous Meckel’s diverticulum causing acute intestinal obstruction in an adult. ANZ J Surg. 2008;78(11):1046–7.CrossRefGoogle Scholar
  18. 18.
    Nunes QM, Hotouras A, Tiwari S, Sheth A. Gangrene due to axial torsion of a Giant Meckel’s Diverticulum containing multiple stones in the lumen: a case report. Cases J. 2009;2:7141.CrossRefGoogle Scholar
  19. 19.
    Runyowa M, Al Samaraee A, Rajagopa R, Kalbassi MR, Bhattacharya V. Unusual case of small bowel strangulation due to Meckel’s diverticulum. Am J Case Rep. 2009;10:9–11.Google Scholar
  20. 20.
    Ruiz L VA, Camacho O LA, Díaz T DC. Giant Meckel’ s diverticula with necrosis due to axial torsion. Revista Colombiana de Gastroenterologia. 2010;25(4):406–8.Google Scholar
  21. 21.
    Halliday AJ, Jamieson RW, Gillies TE. Meckels diverticulum and intestinal ischaemia. J Surg Case Reports. 2011;1(2):31–3.Google Scholar
  22. 22.
    Cartanese C, Petitti T, Marinelli E, Pignatelli A, Martignetti D, Zuccarino M et al. Intestinal obstruction caused by torsed gangrenous Meckel’s diverticulum encircling terminal ileum. World J Gastrointest Surg. 2011;3(7):106–9.CrossRefGoogle Scholar
  23. 23.
    Nose S, Okuyama H, Sasaki T, Nisimura M. Torsion of Meckel’s Diverticulum in a Child. Case Rep Gastroenterol. 2013;8501:14–8.CrossRefGoogle Scholar
  24. 24.
    Sasikumar K, Noonavath RN, Sreenath GS, Maroju NK. Axial torsion of gangrenous Meckel’s diverticulum causing small bowel obstruction. J Surg Tech Case Rep. 2013;5(2):103–5.CrossRefGoogle Scholar

Copyright information

© Japanese Society of Gastroenterology 2019

Authors and Affiliations

  1. 1.Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la SaludMonterreyMexico
  2. 2.Hospital Metropolitano “Dr. Bernando Sepúlveda”Nuevo LeónMexico

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