Inverted Meckel's diverticulum associated with heterotopic pancreatic tissue causing intestinal obstruction: a case report

Abstract

Meckel’s diverticulum is the most frequent congenital anomaly of the gastrointestinal tract, and it occurs in approximately 2% of the general population. It results from incomplete atrophy of the omphalomesenteric (vitelline) duct (Levy and Hobbs 2004). It can invert or invaginate into the small intestine lumen. When occurring, the mesenteric fat surrounding the Meckel’s diverticulum is pulled into the center and can progress into intussusception or bowel obstruction. These consequences could be very dangerous if they are not diagnosed and may lead to perforation, bowel necrosis, and sepsis (Levy and Hobbs 2004; Dujardin et al. 2002).

Meckel’s diverticulum complications risk varies widely from 4 to 40% (Elsayes et al. (2007); Fink et al. 1995). The most common presentation in adults is bowel obstruction (Sagar et al. 2006). Heterotopic pancreatic tissue is a congenital anomaly in which pancreatic tissue is anatomically separate from the main pancreatic gland with no vascular or duct continuity (Kung et al. 2010; Wei et al. 2011). The most frequent locations are the stomach (25.5%), duodenum (27.7%), proximal jejunum (15.9%), Meckel diverticulum (5.3%), and ileum (2.8%) (Wei et al. 2011).