Mechanical ileus of the small bowel due to an inflamed Meckel’s diverticulum with an enterolith – a case report with literature review

• Published in: Acta chirurgica belgica 2023-11, Vol.123 (6), p.699-706
• Main Authors: De Dyn, Stephan, Demirci, Ilhan, Prescher, Andreas, Kopp, Andreas, Klosterhalfen, Bernd, Janßen, Hermann
• Format: Article
• Language: English
• ISSN: 0001-5458; 2577-0160
• DOI: 10.1080/00015458.2022.2136047

BACKGROUNDMeckel's diverticula result from incomplete obliteration and regression of the omphaloenteric duct and are the most common congenital intestinal malformations. Many Meckel's diverticula remain asymptomatic and are discovered as incidental findings. They present a diagnostic challenge.METHODSWe report the case of a 35-year-old man who presented with an acute abdomen and ileus. Computed tomography of the abdomen showed a mechanical small bowel ileus. There was a calibre jump in the terminal ileum with a round endoluminal definable hyperdense structure of almost 2 cm in diameter.RESULTSAn exploratory laparoscopy was performed revealing an inflamed Meckel's diverticulum with impacted enterolith as the cause of the intestinal obstruction.CONCLUSIONIn symptomatic Meckel's diverticula, haemorrhage and obstruction are the most common complications. The development of ileus due to a Meckel's diverticulum with an enterolith is considered extremely rare but should be taken into account.