Meckel's diverticulum axial torsion: A rare complication case report of a 5-year-old girl

INTRODUCTION: Meckel's diverticulum is the most common congenital malformation of the gastrointestinal tract. Axial torsion of the diverticulum followed by gangrene is the rarest complication that can occur mainly in children. CASE PRESENTATION: A 5-year-old girl complaining of vomiting, fever and abdominal pain came to hospital. In Laboratory findings, leukocytosis (WBC = 22.5 ∗ 10(3)/μl) was observed and mild interloop fluid with a whirlpool-like structure which suggests volvulus like obstruction was seen in sonography. The patient underwent emergency laparotomy. A necrotic congested Meckel's diverticulum was found during the surgery, which was axially twisted. After the operation, the patient recovered and was discharged six days later. DISCUSSION: Axial twisting of Meckel's diverticulum is known as one of the rarest related complications, and it is caused by the rotation of the diverticulum around its axis. Among the factors that can make Meckel's diverticulum prone to twisting are its connection to the intestinal mesentery or the umbilical cord, or the presence of mesodiverticular bands. One of the appropriate diagnostic methods is the use of technetium-99. In Cases of small bowel obstruction, diverticulectomy and segmental or wedge resection have been introduced as suitable surgical methods. The delay in diagnosing a complex Meckel's diverticulum can lead to complications and mortality. CONCLUSION: Rapid management of Meckel's diverticulum, which has become challenging due to its difficult diagnosis, is very important to obtain acceptable results.