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Báo cáo y học: " Axial torsion as a rare and unusual complication of a Meckel’s diverticulum: a case report and review of the literature"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Axial torsion as a rare and unusual complication of a Meckel’s diverticulum: a case report and review of the literature. | Seth and Seth Journal of Medical Case Reports 2011 5 118 http www.jmedicalcasereports.eom content 5 1 118 JOURNALOF medical Ur Case REPORTS CASE REPORT Open Access Axial torsion as a rare and unusual complication of a Meckel s diverticulum a case report and review of the literature Ajai Seth 1 and Jai Seth2 Abstract Introduction 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. Case presentation 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. Conclusion 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 .