[Rare Clinical Case of a Small Intestine Ileus Following an Invaginated Meckel's Diverticulum].

Medical History And Clinical Findings:  A 43-year old male patient was admitted because of diffuse abdominal discomfort for two days, which had started in the upper abdomen; medical history, no previous surgical interventions at the abdomen.

Investigations:  Gastroscopy and abdominal ultrasound revealed only a mild gastritis. Laboratory parameters: showed only a slight leucocytosis (10 610/µL). On the 1st day of the hospital stay, the patient developed a worsening of the abdominal symptoms with distended abdomen, sounding bowel movements and recurrent vomiting, which were interpreted as acute abdomen by the surgeon on call leading to the indication of a surgical intervention. CT scan revealed an intraluminal tumor.

Diagnosis:  Suspicion of a mechanical ileus by an obstructing tumor of the small intestine.

Therapy:  Median laparotomy of the lower abdomen revealed an invagination at the terminal ileum - after devagination, an invaginated Meckel's diverticulum was found. This was resected at its basis and the ileal wall was transversally sutured.

Course:  The postoperative course was uneventful.

Discussion (conclusion):  An invaginated Meckel's diverticulum belongs rather to the less frequent causes of an ileus of the small intestine and an unclear / acute abdomen in adults.