Cargando…

Acute abdomen following axial torsion of a Giant Meckel's diverticulum in a young male: A case report

INTRODUCTION AND IMPORTANCE: Among Meckel's diverticulum (MD), the ‘Giant’ category is relatively rare. Most Giant MDs lead to complications such as torsion and diverticulitis. PRESENTATION OF CASE: A 20-year-old South Asian male presented with a three-day history of vomiting and left-sided abd...

Descripción completa

Detalles Bibliográficos
Autores principales: Munasinghe, B.M., Dhanuksha, D.C., Samarathunga, R.D., Senevirathne, P.S.M.B., Karunatileke, C.T.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9568704/
https://www.ncbi.nlm.nih.gov/pubmed/36099772
http://dx.doi.org/10.1016/j.ijscr.2022.107631
_version_ 1784809695265947648
author Munasinghe, B.M.
Dhanuksha, D.C.
Samarathunga, R.D.
Senevirathne, P.S.M.B.
Karunatileke, C.T.
author_facet Munasinghe, B.M.
Dhanuksha, D.C.
Samarathunga, R.D.
Senevirathne, P.S.M.B.
Karunatileke, C.T.
author_sort Munasinghe, B.M.
collection PubMed
description INTRODUCTION AND IMPORTANCE: Among Meckel's diverticulum (MD), the ‘Giant’ category is relatively rare. Most Giant MDs lead to complications such as torsion and diverticulitis. PRESENTATION OF CASE: A 20-year-old South Asian male presented with a three-day history of vomiting and left-sided abdominal pain. X-ray and ultrasound scan of the abdomen illustrated features of small bowel obstruction. He underwent laparotomy under general anaesthesia. A gangrenous, axially torsed 25-cm Giant MD with concurrent ileal compression by a mesodiverticular band was detected and diverticulectomy and segmental resection with end-to-end anastomosis of the ileum was performed. Histology revealed ectopic gastric and pancreatic tissue. He had an uneventful postoperative stay and was devoid of any surgery-related complications at one-year follow-up. CLINICAL DISCUSSION: Adults mainly present with bowel obstruction following complicated MDs. Multiple mechanisms have been elaborated as causalities of bowel obstruction where the presence of bands of congenital or inflammatory origin, intussusception, and enteroliths are relatively common. The presence of ectopic tissue in MDs is associated with increased complications. Symptomatic MDs need resection to abate future complications such as haemorrhage and obstruction. CONCLUSION: Despite the low diagnostic potential of clinical examination and radiological studies, a high degree of suspicion is warranted in cases of probable MD-resultant complications, where more common aetiologies have been ruled out, as delay in diagnosis and definitive surgical therapy are invariably associated with worsened morbidity and mortality. It is high time to elucidate related demographics and clinical data on Giant MDs to identify high-risk categories and develop safer follow-up protocols.
format Online
Article
Text
id pubmed-9568704
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Elsevier
record_format MEDLINE/PubMed
spelling pubmed-95687042022-10-16 Acute abdomen following axial torsion of a Giant Meckel's diverticulum in a young male: A case report Munasinghe, B.M. Dhanuksha, D.C. Samarathunga, R.D. Senevirathne, P.S.M.B. Karunatileke, C.T. Int J Surg Case Rep Case Report INTRODUCTION AND IMPORTANCE: Among Meckel's diverticulum (MD), the ‘Giant’ category is relatively rare. Most Giant MDs lead to complications such as torsion and diverticulitis. PRESENTATION OF CASE: A 20-year-old South Asian male presented with a three-day history of vomiting and left-sided abdominal pain. X-ray and ultrasound scan of the abdomen illustrated features of small bowel obstruction. He underwent laparotomy under general anaesthesia. A gangrenous, axially torsed 25-cm Giant MD with concurrent ileal compression by a mesodiverticular band was detected and diverticulectomy and segmental resection with end-to-end anastomosis of the ileum was performed. Histology revealed ectopic gastric and pancreatic tissue. He had an uneventful postoperative stay and was devoid of any surgery-related complications at one-year follow-up. CLINICAL DISCUSSION: Adults mainly present with bowel obstruction following complicated MDs. Multiple mechanisms have been elaborated as causalities of bowel obstruction where the presence of bands of congenital or inflammatory origin, intussusception, and enteroliths are relatively common. The presence of ectopic tissue in MDs is associated with increased complications. Symptomatic MDs need resection to abate future complications such as haemorrhage and obstruction. CONCLUSION: Despite the low diagnostic potential of clinical examination and radiological studies, a high degree of suspicion is warranted in cases of probable MD-resultant complications, where more common aetiologies have been ruled out, as delay in diagnosis and definitive surgical therapy are invariably associated with worsened morbidity and mortality. It is high time to elucidate related demographics and clinical data on Giant MDs to identify high-risk categories and develop safer follow-up protocols. Elsevier 2022-09-09 /pmc/articles/PMC9568704/ /pubmed/36099772 http://dx.doi.org/10.1016/j.ijscr.2022.107631 Text en © 2022 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Munasinghe, B.M.
Dhanuksha, D.C.
Samarathunga, R.D.
Senevirathne, P.S.M.B.
Karunatileke, C.T.
Acute abdomen following axial torsion of a Giant Meckel's diverticulum in a young male: A case report
title Acute abdomen following axial torsion of a Giant Meckel's diverticulum in a young male: A case report
title_full Acute abdomen following axial torsion of a Giant Meckel's diverticulum in a young male: A case report
title_fullStr Acute abdomen following axial torsion of a Giant Meckel's diverticulum in a young male: A case report
title_full_unstemmed Acute abdomen following axial torsion of a Giant Meckel's diverticulum in a young male: A case report
title_short Acute abdomen following axial torsion of a Giant Meckel's diverticulum in a young male: A case report
title_sort acute abdomen following axial torsion of a giant meckel's diverticulum in a young male: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9568704/
https://www.ncbi.nlm.nih.gov/pubmed/36099772
http://dx.doi.org/10.1016/j.ijscr.2022.107631
work_keys_str_mv AT munasinghebm acuteabdomenfollowingaxialtorsionofagiantmeckelsdiverticuluminayoungmaleacasereport
AT dhanukshadc acuteabdomenfollowingaxialtorsionofagiantmeckelsdiverticuluminayoungmaleacasereport
AT samarathungard acuteabdomenfollowingaxialtorsionofagiantmeckelsdiverticuluminayoungmaleacasereport
AT senevirathnepsmb acuteabdomenfollowingaxialtorsionofagiantmeckelsdiverticuluminayoungmaleacasereport
AT karunatilekect acuteabdomenfollowingaxialtorsionofagiantmeckelsdiverticuluminayoungmaleacasereport