BACKGROUND

Meckel's diverticulum is the most common congenital anomaly of the small bowel and is caused by the incomplete obliteration of the omphalomesenteric duct during the eighth week of gestation.

METHODS

We report the case of a 51-year-old male who presented to the emergency department with epigastric pain, vomiting, and abdominal distension. Clinically, he had a high intestinal obstruction without any mechanical cause on computed tomography scan. A median laparotomy was proposed.

RESULTS

An internal ileum hernia was identified twisted around a giant Meckel's diverticulum with a mesodiverticular artery, coursing from the base of the mesentery to the diverticulum. A small bowel segmental resection was performed, containing the diverticulum. Histology revealed a 15-cm long Meckel's diverticulum with no heterotopic mucosa.

CONCLUSION

Small bowel obstruction due to an internal ileum hernia twisted around a giant Meckel's diverticulum with a mesodiverticular artery is very rare, and its diagnosis is challenging, requires a high level of suspicion, and it is only performed by exploratory surgery.