A Case of Perforated Meckel's Diverticulum Caused by Torsion of Its Neck.

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  • Fukuda Naoto
    Critical Cara and Emergency Medical Center, Yokohama City University
  • Okubo Kenji
    Critical Cara and Emergency Medical Center, Yokohama City University
  • Yoda Kouhei
    Critical Cara and Emergency Medical Center, Yokohama City University
  • Ito Shigeyoshi
    Critical Cara and Emergency Medical Center, Yokohama City University
  • Ozawa Yukihiro
    Critical Cara and Emergency Medical Center, Yokohama City University
  • Sugiyama Mitsugi
    Critical Cara and Emergency Medical Center, Yokohama City University

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  • メッケル憩室頚部捻転壊死による穿孔性腹膜炎の１例

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Abstract

A case of necrotic Meckel's diverticulum due to torsion at its neck, resulting in perforative peritonitis, is reported. The patient, a 32-year-old man was admitted with the complaint of lower abdominal pain. Emergency laparotomy was performed under the diagnosis of acute peritonitis; Meckel's diverticulum, 8.5×5.0cm in size, was found to protrude from the lateral wall of the ileum about 50cm proximal to Bauhin's valve, and was voluvulated about 360 degrees clockwise at its neck and necrotized. Perforation, 2mm in diameter, was present at the body of the diverticulum, causing acute pan-peritonitis. Partial resection of the ileum and peritoneal lavage were performed. Torsion is a rare complication of Meckel's diverticulum, and we found only 9 reported cases, including ours, in Japan. Those cases were also large in size, greater than 6cm (mean 11.5cm) in length, and had a narrow neck of the diverticulum. It is thought that large size and a narrow neck of the diverticulum may be an anatomical factor in torsion of Meckel's diverticulum.

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