Case Report

J Minim Invasive Surg 2015; 18(3): 86-88

Published online September 15, 2015

https://doi.org/10.7602/jmis.2015.18.3.86

© The Korean Society of Endo-Laparoscopic & Robotic Surgery

Laparoscopic Treatment of Gangrene of Giant Meckel’s Diverticulum Secondary to Axial Torsion

Gui-Ae Jeong, M.D., Zisun Kim, M.D.

Departments of Surgery, Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon, Korea

Received: June 8, 2015; Revised: July 13, 2015; Accepted: August 24, 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Meckel’s diverticulum is a common congenital anomaly in the small bowel. Most cases of Meckel’s diverticulum are asymptomatic and are found incidentally. We herein report on a case of a 21-yearold male patient who complained of lower abdominal pain and febrile sensation with incidentally diagnosed gangrenous change of Meckel’s diverticulum due to axial torsion itself. A 21-year-old man presented to our institution with acute lower abdominal pain. No accurate focus on abdominal pain such as appendicitis or diverticulitis was observed on abdominal ultrasonography and abdominal CT scan. However, the physical examination of the patient revealed the symptom of localized peritonitis with fever. Finally, laparoscopic exploration was performed to determine the cause of acute abdominal pain. During the operation, we found gangrenous change of Meckel’s diverticulum with axial torsion itself and laparoscopic Meckel’s diverticulectomy was performed. The patient made an uneventful recovery and was discharged on the 6th postoperative day.

Keywords Meckel Diverticulum, Torsion Abnormality, Laparoscopy

  1. Yahchouchy EK, Marano AF, Etienne JC, Fingerhut AL. Meckel's diverticulum. J Am Coll Surg 2001;192:658-662.
    CrossRef
  2. Soltero MJ, Bill AH. The natural history of Meckel's Diverticulum and its relation to incidental removal. A study of 202 cases of diseased Meckel's Diverticulum found in King County, Washington, over a fifteen year period. Am J Surg 1976;132:168-173.
    CrossRef
  3. Townsend CM Jr., Beauchamp RD, Evers BM, Mattox KL. Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 19th ed. Phildelphia: Saunders; 2012.
  4. Eser M, Oncel M, Kurt N. Gangrene secondary to axial torsion in a patient with Meckel's diverticulum. Int Surg 2002;87:104-106.
    Pubmed
  5. Tan YM, Zheng ZX. Recurrent torsion of a giant Meckel's diverticulum. Dig Dis Sci 2005;50:1285-1287.
    CrossRef
  6. Prasad TR, Chui CH, Jacobsen AS. Laparoscopic resection of an axially torted Meckel's diverticulum in a 13-year-old. J Laparoendosc Adv Surg Tech A 2006;16:425-427.
    Pubmed CrossRef
  7. Seth A, Seth J. Axial torsion as a rare and unusual complication of a Meckel's diverticulum: a case report and review of the literature. J Med Case Rep 2011;5:118.
    Pubmed KoreaMed CrossRef
  8. Hadeed AA, Azar RR, Azar NN, Benninger B. Meckel's diverticulum complicated by axial torsion and gangrene. J Surg Case Rep 2015;pii: rjv008.
    Pubmed KoreaMed CrossRef
  9. Nose S, Okuyama H, Sasaki T, Nishimura M. Torsion of Meckel's Diverticulum in a Child. Case Rep Gastroenterol 2013;7:14-18.
    Pubmed KoreaMed CrossRef
  10. Varcoe RL1, Wong SW, Taylor CF, Newstead GL. Diverticulectomy is inadequate treatment for short Meckel's diverticulum with heterotopic mucosa. ANZ J Surg 2004;74:869-872.
    Pubmed CrossRef

Article

Case Report

J Minim Invasive Surg 2015; 18(3): 86-88

Published online September 15, 2015 https://doi.org/10.7602/jmis.2015.18.3.86

Copyright © The Korean Society of Endo-Laparoscopic & Robotic Surgery.

Laparoscopic Treatment of Gangrene of Giant Meckel’s Diverticulum Secondary to Axial Torsion

Gui-Ae Jeong, M.D., Zisun Kim, M.D.

Departments of Surgery, Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon, Korea

Received: June 8, 2015; Revised: July 13, 2015; Accepted: August 24, 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Meckel’s diverticulum is a common congenital anomaly in the small bowel. Most cases of Meckel’s diverticulum are asymptomatic and are found incidentally. We herein report on a case of a 21-yearold male patient who complained of lower abdominal pain and febrile sensation with incidentally diagnosed gangrenous change of Meckel’s diverticulum due to axial torsion itself. A 21-year-old man presented to our institution with acute lower abdominal pain. No accurate focus on abdominal pain such as appendicitis or diverticulitis was observed on abdominal ultrasonography and abdominal CT scan. However, the physical examination of the patient revealed the symptom of localized peritonitis with fever. Finally, laparoscopic exploration was performed to determine the cause of acute abdominal pain. During the operation, we found gangrenous change of Meckel’s diverticulum with axial torsion itself and laparoscopic Meckel’s diverticulectomy was performed. The patient made an uneventful recovery and was discharged on the 6th postoperative day.

Keywords: Meckel Diverticulum, Torsion Abnormality, Laparoscopy

References

  1. Yahchouchy EK, Marano AF, Etienne JC, Fingerhut AL. Meckel's diverticulum. J Am Coll Surg 2001;192:658-662.
    CrossRef
  2. Soltero MJ, Bill AH. The natural history of Meckel's Diverticulum and its relation to incidental removal. A study of 202 cases of diseased Meckel's Diverticulum found in King County, Washington, over a fifteen year period. Am J Surg 1976;132:168-173.
    CrossRef
  3. Townsend CM Jr., Beauchamp RD, Evers BM, Mattox KL. Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 19th ed. Phildelphia: Saunders; 2012.
  4. Eser M, Oncel M, Kurt N. Gangrene secondary to axial torsion in a patient with Meckel's diverticulum. Int Surg 2002;87:104-106.
    Pubmed
  5. Tan YM, Zheng ZX. Recurrent torsion of a giant Meckel's diverticulum. Dig Dis Sci 2005;50:1285-1287.
    CrossRef
  6. Prasad TR, Chui CH, Jacobsen AS. Laparoscopic resection of an axially torted Meckel's diverticulum in a 13-year-old. J Laparoendosc Adv Surg Tech A 2006;16:425-427.
    Pubmed CrossRef
  7. Seth A, Seth J. Axial torsion as a rare and unusual complication of a Meckel's diverticulum: a case report and review of the literature. J Med Case Rep 2011;5:118.
    Pubmed KoreaMed CrossRef
  8. Hadeed AA, Azar RR, Azar NN, Benninger B. Meckel's diverticulum complicated by axial torsion and gangrene. J Surg Case Rep 2015;pii: rjv008.
    Pubmed KoreaMed CrossRef
  9. Nose S, Okuyama H, Sasaki T, Nishimura M. Torsion of Meckel's Diverticulum in a Child. Case Rep Gastroenterol 2013;7:14-18.
    Pubmed KoreaMed CrossRef
  10. Varcoe RL1, Wong SW, Taylor CF, Newstead GL. Diverticulectomy is inadequate treatment for short Meckel's diverticulum with heterotopic mucosa. ANZ J Surg 2004;74:869-872.
    Pubmed CrossRef

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