Gangrene of Meckel's Diverticulum Secondary to Axial Torsion in a Child: An Unusual Complication

Abstract

Axial torsion and gangrene of Meckel's diverticulum (MD) causing small bowel obstruction is the rarest complication of the congenital anomaly. Only 8 cases in children and approximately 20 cases in adults were found in the literature. Our case is a 2-year-old Caucasian male who presented to our pediatric department with gastroenteritis. The following day bilious vomiting and colicky episodic abdominal pain started. Clinical and laboratory findings were suggestive of acute intestinal obstruction or appendicitis. Exploratory laparotomy suggested that 2 peritoneal bands of diverticulum to the mesentery of non-adjacent small bowel were the cause of axial torsion of MD; herniation of small bowels under the bands were observed. Wedge resection of the MD was performed. Complicated MD has no specific value. The preoperative diagnosis is difficult. Early surgery is important for correct diagnosis and for preventing strangulation and gangrene of the bowel.