Incarcerated ventral (epigastric) hernia containing a strangulated Meckel's diverticulum

Summary

A Meckel's diverticulum is the result of an incomplete obliteration of the omphalomesenteric, or vitelline, duct. The duct connects the midgut to the yolk sac of the developing intestinal tract and normally atrophies by the eighth to ninth week of gestation. This event fails to occur in approximately two percent of the population, resulting in the congenital anomaly named after Johann Friedrich Meckel, who first characterized this diverticulum in 1809. Our patient presented with signs and symptoms consistent with a small bowel obstruction secondary to an incarcerated hernia, and underwent emergent laparotomy. An ischemie small bowel segment with a Meckel's diverticulum was resected. Pathology revealed ectopic pancreatic tissue within the diverticulum. Meckel's diverticula have been observed among the contents of hernia sacs in various locations including the inguinal, femoral, and umbilical regions. We report a case of a Meckel's diverticulum presenting in a spontaneous ventral (epigastric) hernia.