Second-Look Surgery in Intestinal Volvulus Caused by Meckel’s Diverticulum – A Case Report

Abstract

Meckel's diverticulum is the most common manifestation of yolk duct anomalies. The most common forms of presentation are painless gastrointestinal bleeding, intestinal obstruction, and diverticulitis. A previously healthy 19-month-old boy was admitted on the emergency department due to septic and hypovolemic shock. The patient underwent exploratory laparotomy which revealed a Meckel's diverticulum anchored to the mesentery by a fibrous band, causing a volvulus and ischemia. A second-look approach was chosen. He underwent relaparotomy on postoperative day 7, which revealed an improvement of intestinal perfusion. Segmental ileal resection containing Meckel's diverticulum and ileostomy were performed. Few cases are described in the literature for intestinal ischemia secondary to volvulus and, those that do exist, are in the context of intestinal malrotation and not in the presence of a Meckel's diverticulum. With this approach, we were able to preserve a significant amount of bowel, without increasing the risk of short intestine syndrome.