TITLE:
Meckel’s Diverticulum-Induced Small Bowel Obstruction in an Adolescent: A Surgical Management Case Study
AUTHORS:
Maniragaba Dieudonne, Nsanzabagenzi Dionys, Hakizimana Patrick, Nduwimana François, Bizoza Yves
KEYWORDS:
Small Bowel Obstruction, Meckel’s Diverticulum, Jejunostomy, Ileojejunal Resection, Small Bowel Volvulus
JOURNAL NAME:
Open Access Library Journal,
Vol.12 No.4,
April
30,
2025
ABSTRACT: Background: Meckel’s diverticulum is the most prevalent congenital small bowel abnormality, which occurs when the omphalomesenteric duct fails to completely obliterate during the eighth week of pregnancy. Only 4% - 16% of individuals exhibit symptoms, while most patients are asymptomatic. Gastrointestinal bleeding is the most frequent occurrence in children; in contrast, intestinal obstruction is the most common complication in adulthood. The majority of Meckel’s diverticula are discovered incidentally during surgery for another reason, and they are more common in male patients. This case report aimed to describe the diagnosis and treatment of a small bowel obstruction caused by Meckel’s diverticulum in an adolescent patient who underwent successful surgery without complications. Case Presentation: 17-year-old male patient without medical or surgical history, who presented to the emergency department with severe abdominal pain, vomiting for six days duration abdominal distension, tenderness, absent bowel sounds, and stopped stools and flatus. The lab blood test findings were without abnormalties except the high level of creatinin but the plain abdominal radiography revealed dilated loops of the small bowel. A small bowel obstruction was highly suspected diagnosis for this case. In the surgical theatre, an urgent exploratory laparotomy was made, a small bowel volvulus around a bead of Meckel’s diverticulum and necrosis of the entire ileum and part of the jejunum was identified. ileojejunal resection leaving 2 m of jejunum, and jejunostomy in the right iliac fossa were performed. In postoperative time, the patient was admitted in intensive care unit, 48 hours later he was transferred to the surgical ward where the postoperative care was made until the discharge. The course of treatment took 28 days totally. In his assessment 5 months later, any digestive disorders and symptoms found, such as diarrhea and others, no electrolyte imbalances occurred in the postoperative period. Conclusion: Small bowel obstruction caused by a Meckel’s diverticulum is a rare and diagnostically challenging condition. Preoperative diagnosis requires a high level of suspicion, particularly in settings where advanced imaging is limited. In such cases, exploratory laparotomy remains the most reliable method for an accurate diagnosis.