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AN ACUTE SMALL BOWEL OBSTRUCTION DUE TO VITELLINE DUCT REMNANT ASSOCIATED WITH GIANT TORSED GANGRENOUS MECKELS DIVERTICULUM - A RARE CASE REPORT.

SUSHANTH S SHIVARAMGOWDA

Abstract


Meckels diverticulum (MD) is considered the most common congenital anomaly of the gastrointestinal tract. It may result in a number of complications including hemorrhage, obstruction, and inflammation. Obstruction of various types is the most common presenting symptom in the adult population. Loop formations with the end of an MD and adjacent mesentery constricting the distal ileum are an  uncommon cause of obstruction. Axial torsion and gangrene of MD is the rarest of the complications. The correct diagnosis of complicated MD before surgery is often difficult because this condition may mimic other acute abdominal pathologies. Delay in the diagnosis of a complicated MD can lead to  significant morbidity and mortality. Here we describe the case of a patient with a very rare form of acute small bowel             obstruction due to constriction of ileum by fibrous band         extending from tip of MD to anterior parietal wall, associated with giant torsed gangrenous MD.

 


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Yahchouchy EK, Marano AF, Etienne JC, Fingerhut AL. Meckel’s diverticulum. J Am Coll Surg 2001; 192: 658-662 2

Prall RT, Bannon MP, Bharucha AE. Meckel’s diverticulum causing intestinal obstruction. Am J Gastroenterol 2001; 96: 3426-3427 3

Tan YM, Zheng ZX. Recurrent torsion of a giant Meckel’s diverticulum. Dig Dis Sci 2005; 50: 1285-1287 4

Dumper J, Mackenzie S, Mitchell P, Sutherland F, Quan ML, Mew D. Complications of Meckel’s diverticula in adults. Can J Surg 2006; 49: 353-3 57 5

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: 1373-1375

Sharma RK, Jain VK, Kamboj S, Murari K. Gangrenous Meckel’s diverticulum causing acute intestinal obstruction in an adult. ANZ J Surg 2008; 78: 1046-1047 7

Rivas H, Cacchione RN, Allen JW. Laparoscopic management of Meckel’s diverticulum in adults. Surg Endosc 2003; 17: 620-622

Neidlinger NA, Madan AK, Wright MJ. Meckel’s diverticulum causing cecal volvulus. Am Surg 2001; 67: 41-43 9

Codrich D, Taddio A, Schleef J, Ventura A, Marchetti F. Meckel’s diverticulum masked by a long period of intermit- tent recurrent subocclusive episodes. World J Gastroenterol 2009; 15: 2809-281110

Bani-Hani KE, Shatnawi NJ. Meckel’s diverticulum: comparison of incidental and symptomatic cases. World J Surg 2004; 28: 917-920

Leijonmarck CE, Bonman-Sandelin K, Frisell J, Räf L. Meckel’s diverticulum in the adult. Br J Surg 1986; 73: 146-149

Tomczak M, Daciewicz Z, Owczarczyk B. [Case of torsion of giant Meckel’s diverticulum]. WiadLek 1980; 33: 571-573

Limas C, Seretis K, Soultanidis C, Anagnostoulis S. Axial torsion and gangrene of a giant Meckel’s diverticulum. J Gastro intestin Liver Dis 2006; 15: 67-68

Eser M, Oncel M, Kurt N. Gangrene secondary to axial torsion in a patient with Meckel’s diverticulum. Int Surg 2002; 87: 104-106

Kiyak G, Ergul E, Sarikaya SM, Kusdemir A. Axial torsionand gangrene of a giant Meckel’s diverticulum mimicking acute appendicitis. J Pak Med Assoc 2009; 59: 408-409

Mackey WC, Dineen P. A fifty year experience with Meckel’ s diverticulum. Surg Gynecol Obstet 1983; 156: 56-64

Elsayes KM, Menias CO, Harvin HJ, Francis IR. Imaging manifestations of Meckel’s diverticulum. AJR Am J Roentgenol 2007; 189: 81-88

You JS, Chung SP, Park YS, Yu JS, Park YA. A case of stran- gulated small bowel obstruction caused by Meckel’s diverticulum in an adult. J Emerg Med 2007; 33: 133-135

Baniani KE, Shatnawi NJ. Meckel's diverticulum: comparison of incidental and symptomatic cases. World J Surg 2004; 28: 917-920

Lüdtke FE, Mende V, Köhler H, Lepsien G. Incidence and frequency or complications and management of Meckel’s diverticulum. SurgGynecolObstet 1989; 169: 537-542

Thurley PD, Halliday KE, Somers JM, Al-Daraji WI, Ilyas M, Broderick NJ. Radiological features of Meckel’s diverticulum and its complications. ClinRadiol 2009; 64: 109-118

Rossi P, Gourtsoyiannis N, Bezzi M, Raptopoulos V, Massa R, Capanna G, Pedicini V, Coe M. Meckel’s diverticulum: imaging diagnosis. AJR Am J Roentgenol 1996; 166: 567-573

Miele V, De Cicco ML, Andreoli C, Buffa V, Adami L, David V. [US and CT findings in complicated Meckeldiverticulum]. Radiol Med 2001; 101: 230-234

Vork JC, Kristensen IB. Meckel’s diverticulum and intestinal obstruction--report of a fatal case. Forensic SciInt 2003; 138: 114-115

Cullen JJ, Kelly KA, Moir CR, Hodge DO, Zinsmeister AR, Melton LJ. Surgical management of Meckel’s diverticulum. An epidemiologic, population-based study. Ann Surg 1994; 220: 564-568; discussion 568-569

Jayeshsagar, vikaskumar, D K shah. Meckeldiverticulum; a systemic review. Journal of royal society of medicine. 99. 501-505; 2006.

Raj kumar sharma and vir kumar jain; emergency surgery for meckel’s diverticulum. World j of emg surg.2008. 1186/1749-7922-3-27.


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