Meckel´s diverticulum located at the mesenteric edge of the ileum in an adult male: case report

Abstract

Meckel’s diverticulum (MD) is the most common congenital malformation of the gastrointestinal tract and occurs in 2-3% of the population. It is a true intestinal diverticulum that results from failure of the vitelline duct to obliterate during the fifth week of fetal development. Very few cases of ileal mesenteric edge location have been reported in the literature. We report a case of a 33 year old male, who presented with clinical signs of localised peritonitis. At laparotomy we found a perforated appendix with localised peritonitis. An incidental finding of a MD was discovered at about 70cms from the ileocecal valve. Macroscopic examination revealed an out pouching growth of 32mm in length, 12mm in diameter with the distal end being slightly bulbous. A segmental resection of the MD with primary anastomosis was performed. The ileal mesenteric edge locations of MD have been reported by a few other authors. The fact that the condition is not reported in large series could contribute to its consideration as bowel duplication. Because there is a high risk of ileal mesenteric MD to erode the mesenteric vasculature and cause devastating consequences, we advocate for systematic resection of ileal mesenteric MD in absence of other contraindications. We believe the ileal mesenteric location is a variant of the classical antimesenteric location. Finding a MD on the ileal mesenteric edge is exceptionally rare.

Keywords

• ileum
• mesentery
• meckel´s diverticulum