Axial torsion as a rare and unusual complication of a Meckel's diverticulum: a case report and review of the literature
<p>Abstract</p> <p>Introduction</p> <p>In 1809, Johann Friedrich Meckel described the embryology of a small bowel diverticulum, which now bears his name. Meckel's diverticulum is the most common congenital abnormality of the gastrointestinal tract, with a prevalenc...
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| Format: | Article |
| Language: | English |
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BMC
2011-03-01
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| Series: | Journal of Medical Case Reports |
| Online Access: | http://www.jmedicalcasereports.com/content/5/1/118 |
| _version_ | 1811299054321139712 |
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| author | Seth Jai Seth Ajai |
| author_facet | Seth Jai Seth Ajai |
| author_sort | Seth Jai |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Introduction</p> <p>In 1809, Johann Friedrich Meckel described the embryology of a small bowel diverticulum, which now bears his name. Meckel's diverticulum is the most common congenital abnormality of the gastrointestinal tract, with a prevalence ranging from 1% to 4% of the population. The majority are clinically silent and are incidentally identified at surgery or at autopsy. The lifetime risk of complications is estimated at 4%, with most of these complications occurring in adults. It is these cases that can cause problems for the clinician, as the diagnosis can be elusive and the consequences extremely serious.</p> <p>Case presentation</p> <p>We present the case of a 68-year-old Caucasian man with axial torsion of a Meckel's diverticulum around its base, a rare complication. He presented with acute, severe abdominal pain, and a clinical diagnosis of perforated acute appendicitis was made. Laparotomy revealed a torted Meckel's diverticulum with distal necrosis and perforation, which was resected. His recovery was uncomplicated, and he was discharged to home six days post-operatively.</p> <p>Conclusion</p> <p>Torsion is an extremely rare complication of Meckel's diverticulum. Its presentation can be elusive, and it can mimic a number of different, more common intra-abdominal pathologies. Imaging appears to be an unreliable diagnostic tool, and the diagnosis is usually made intra-operatively. Factors pre-disposing these patients to axial torsion of Meckel's diverticulum include the presence of mesodiverticular bands, a narrow base, excessive length, and associated neoplastic growth or inflammation of the diverticulum. The importance of searching for a diseased Meckel's diverticulum at laparotomy in appropriate circumstances is highlighted. Once identified, prompt surgical excision generally leads to an uncomplicated recovery.</p> |
| first_indexed | 2024-04-13T06:30:24Z |
| format | Article |
| id | doaj.art-d140bfd4b0814fa08e6b2388bab59809 |
| institution | Directory Open Access Journal |
| issn | 1752-1947 |
| language | English |
| last_indexed | 2024-04-13T06:30:24Z |
| publishDate | 2011-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Medical Case Reports |
| spelling | doaj.art-d140bfd4b0814fa08e6b2388bab598092022-12-22T02:58:13ZengBMCJournal of Medical Case Reports1752-19472011-03-015111810.1186/1752-1947-5-118Axial torsion as a rare and unusual complication of a Meckel's diverticulum: a case report and review of the literatureSeth JaiSeth Ajai<p>Abstract</p> <p>Introduction</p> <p>In 1809, Johann Friedrich Meckel described the embryology of a small bowel diverticulum, which now bears his name. Meckel's diverticulum is the most common congenital abnormality of the gastrointestinal tract, with a prevalence ranging from 1% to 4% of the population. The majority are clinically silent and are incidentally identified at surgery or at autopsy. The lifetime risk of complications is estimated at 4%, with most of these complications occurring in adults. It is these cases that can cause problems for the clinician, as the diagnosis can be elusive and the consequences extremely serious.</p> <p>Case presentation</p> <p>We present the case of a 68-year-old Caucasian man with axial torsion of a Meckel's diverticulum around its base, a rare complication. He presented with acute, severe abdominal pain, and a clinical diagnosis of perforated acute appendicitis was made. Laparotomy revealed a torted Meckel's diverticulum with distal necrosis and perforation, which was resected. His recovery was uncomplicated, and he was discharged to home six days post-operatively.</p> <p>Conclusion</p> <p>Torsion is an extremely rare complication of Meckel's diverticulum. Its presentation can be elusive, and it can mimic a number of different, more common intra-abdominal pathologies. Imaging appears to be an unreliable diagnostic tool, and the diagnosis is usually made intra-operatively. Factors pre-disposing these patients to axial torsion of Meckel's diverticulum include the presence of mesodiverticular bands, a narrow base, excessive length, and associated neoplastic growth or inflammation of the diverticulum. The importance of searching for a diseased Meckel's diverticulum at laparotomy in appropriate circumstances is highlighted. Once identified, prompt surgical excision generally leads to an uncomplicated recovery.</p>http://www.jmedicalcasereports.com/content/5/1/118 |
| spellingShingle | Seth Jai Seth Ajai Axial torsion as a rare and unusual complication of a Meckel's diverticulum: a case report and review of the literature Journal of Medical Case Reports |
| title | Axial torsion as a rare and unusual complication of a Meckel's diverticulum: a case report and review of the literature |
| title_full | Axial torsion as a rare and unusual complication of a Meckel's diverticulum: a case report and review of the literature |
| title_fullStr | Axial torsion as a rare and unusual complication of a Meckel's diverticulum: a case report and review of the literature |
| title_full_unstemmed | Axial torsion as a rare and unusual complication of a Meckel's diverticulum: a case report and review of the literature |
| title_short | Axial torsion as a rare and unusual complication of a Meckel's diverticulum: a case report and review of the literature |
| title_sort | axial torsion as a rare and unusual complication of a meckel s diverticulum a case report and review of the literature |
| url | http://www.jmedicalcasereports.com/content/5/1/118 |
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