Meckel's diverticulum (MD) is the most common congenital abnormality of the gastrointestinal tract. It usually lies on the antimesenteric side of the ileum, about 60 cm from the ileocecal valve. Histologically, it is a true diverticulum comprising all four layers of the intestinal tract. Complications associated with MD include bleeding, bowel obstruction, intussusception, and inflammation (diverticulitis). A 12-year-old boy presented to the emergency department with a one-day history of right iliac fossa pain. He had rebound tenderness and localized peritonism. The inflammatory markers were raised. He was listed for an emergency laparoscopic appendicectomy. Intraoperatively, a large necrotic MD was identified, twisted on its pedicle. In addition, a fibrous band extended from the tip of the diverticulum to the posterior aspect of the anterior abdominal wall. A closed-loop, discoloured terminal ileal volvulus with proximal small bowel dilatation was noted. The band was released by sharp dissection, and the terminal ileum volvulus was freed with the return of normal colour and circulation. The gangrenous Meckel's diverticulum was excised at its pedicle by ECHELON FLEX™ ENDOPATH® staplers (Ethicon, Inc., a Johnson & Johnson company, Raritan, NJ). The postoperative recovery was uneventful. Early laparoscopic intervention prevented irreversible small bowel ischaemia that may have resulted in resection of the terminal ileum in a child.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11739730PMC
http://dx.doi.org/10.7759/cureus.77567DOI Listing

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Meckel's diverticulum (MD) is the most common congenital abnormality of the gastrointestinal tract. It usually lies on the antimesenteric side of the ileum, about 60 cm from the ileocecal valve. Histologically, it is a true diverticulum comprising all four layers of the intestinal tract.

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BACKGROUND Meckel's diverticulum is a congenital diverticulum that contains all normal layers of the gastrointestinal wall. In adults, Meckel's diverticulum can present with bowel obstruction, the most common presentation, in 35.6% of cases.

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Meckel's diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract, arising from incomplete obliteration of the vitelline duct. MD contains all layers of the intestinal wall and often remains asymptomatic. Gastrointestinal bleeding, bowel obstruction, and acute diverticulitis occur in a few cases.

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Meckel's diverticulum, a congenital anomaly of the omphalomesenteric duct, is a rare cause of acute abdomen and poses significant diagnostic challenges due to its variable presentation and complications such as perforation. We present the case of a 19-year-old male with a 24-hour history of right iliac fossa pain progressing to generalized abdominal tenderness. Laboratory results showed leukocytosis and elevated C-reactive protein, while CT imaging suggested pneumoperitoneum and an inflamed Meckel diverticulum.

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