A Rare Case of a Meckel's Diverticulum Complicated by a Mesodiverticular Band.

ABSTRACT

A Meckel's diverticulum is a true congenital diverticulum arising from the ileum, approximately 2 feet from the ileocaecal junction. Named after Johann Meckel, who first described its embryological origins, the anomaly remains asymptomatic for most. Uncommonly, it is found to be the cause of serious complications such as interstitial obstruction and/or gangrene, bowel perforation, and, in rare cases, internal bowel herniations. A mesodiverticular band is a congenital fibrous band connecting the Meckel's diverticulum to its own mesentery, predisposing it to complications. Both conditions arise from a failure of regression of the vitellointestinal duct and its feeding artery. The presence of a mesodiverticular band significantly raises the possibility of complications, especially those of internal herniation and subsequent bowel obstruction. Detection of a Meckel's diverticulum is challenging in routine investigations such as contrast-enhanced computed tomography, and scintigraphy with Tc99 is required. The availability of such scans is limited, and their use is further difficult in emergent situations such as intestinal obstruction. This condition is, therefore, more frequently detected at laparotomies. Herein, we report a case of intestinal obstruction in a young female who presented to our emergency room with an acute abdomen and was found to have a mesodiverticular band causing internal herniation and subsequent obstruction.