SMALL BOWEL OBSTRUCTION DUE TO MECKELS DIVERTICULUM IN ADULTS: CASE REPORT

Meckels diverticulum is the partial persistence of the omphalomesenteric duct during the seventh week of gestation [1]. It is the most common congenital anomaly of the gastrointestinal tract with a slight male predominance [1]. It is rare and is encountered in 2 to 4% of the population [2]. Meckels diverticulum is usually, but it can be revealed by complications such as: intestinal obstruction, perforation, fistula and tumor degeneration [3].We report in this work the clinical case and management of small bowel volvulus on Meckels diverticulum, observed in theUniversity Hospital center of Marrakech in a 19-year-old adult in March 2023, this is a patient without medical history admitted to the emergency with acute abdomen made up of abdominal pain, vomiting and fever. The physical examination aimed abdominal bloating and generalized defense. Biology shows an inflammatory syndrome.Abdominal Computed tomography scan in the emergency shows a distension of the small bowel measuring 36mm, with hydroaeric levels, no disparity in caliber, associated with moderate peritoneal effusion.The patient was operated by median laparotomy. Surgical exploration revealed distension of the bowel upstream of a flange taking up an inflamed Meckels diverticulum, 6cm long and 2cm in diameter, situated on the anti-mesenteric edge, 2.30 meters from the Treitz angle and 70cm from the ileo-caecal junction, adhering to the root of the mesentery. It was around this diverticulum that the small intestine had volvulated but was viable. The appendix was normal size. The surgical procedure consisted of a losangicdiverticulectomy preserving the supporting loop of bowel and transverse suture of the loop of bowel using separate stitches.Postoperative recovery was straightforward. Discharge was authorized on the 6th day.Histo-pathological examination showed fibrous tissue with a dense, diffuse inflammatory infiltrate, compatible with a lesion of non-specific gastric diverticulitis.It is important to be aware of the complications of Meckels diverticulum in the presence of acute abdominal pain, to guide surgical management as effectively as possible.