ORIGINAL ARTICLE   

Chirurgia 2021 December;34(6):242-5

DOI: 10.23736/S0394-9508.20.05170-0

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

A different complication of Meckel’s diverticulum: axial torsion

Ali SAYAN ¹, Mehmet MERT ¹ ✉, Gokhan KOYLUOGLU ²

¹ Department of Pediatric Surgery, Tepecik Education and Research Hospital, Izmir, Turkey; ² Department of Pediatric Surgery, Izmir Katip Celebi University, Izmir, Turkey

BACKGROUND: Meckel’s diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract. Complications of MD are intestinal obstruction, bleeding, diverticulitis, umbilical fistula, diverticulum perforation, cecal volvulus. In this study, we aimed to present a case with axial torsion of MD, which is not shown among the complications of MD, also performing a literature search.
METHODS: A 6-year-old male patient was operated urgency and MD was found to be gangrenous by 900 degrees of axial torsion. Articles after categorization were classified according to data.
RESULTS: The patient was operated, and it was seen that MD’s connection with ileum was highly thin. A very thin-torsioned fibrotic band was seen between the MD and the abdominal wall. Upon this, the fibrotic band was excised from umbilicus and MD that nearly separated from ilum was completely removed by diverticulectomy. The perforation area (approximately 3 mm) where MD was attached to the ileum was repaired.
CONCLUSIONS: Depending on the axial torsion of MD, if MD’s connection with the intestine is detached first, it may be thought that MD can be found free in the abdomen or suspended in an anatomical place (such as umbilicus). In this situation, it is thought that perforation clinic may occur if the place where MD leaves from the intestine remains open. For these reasons, it is thought that MD should be searched in the abdomen during the operation in intestinal perforations without an organic pathology.

KEY WORDS: Diverticular diseases; Gangrene; Meckel diverticulum