Meckels diverticulum and intestinal ischaemia

We report an exceptional case of intestinal ischaemia requiring resection, secondary to torsion around a long Meckel’s diverticulum. Meckel’s diverticulum is an uncommon congenital abnormality of the small bowel. Meckel’s diverticulum giving rise to intestinal ischaemia that requires resection is very rare but potentially fatal complication. A 62 year old woman presented as an emergency with sudden onset upper abdominal pain and vomiting. Clinical suspicion of cholecystitis prompted an ultrasound scan which revealed a distended gallbladder with multiple gallstones and an otherwise normal abdomen. Laparoscopy revealed a large volume of free blood in all four quadrants and a loop of gangrenous small bowel. The case was converted to laparotomy and a 640 mm loop of infarcted small bowel, torted around a Meckel’s diverticulum, was resected. Detection of a complication arising from a Meckel’s diverticulum presents a diagnostic challenge and can be mistaken for more common surgical presentations.