The rarest complication of Meckel's diverticulum

Meckel's diverticulum (MD) is the most common congenital anomaly of the small intestine. Most MDs are asymptomatic, usually incidentally found by imaging or during surgery. Complications of MD include small bowel obstruction (SBO), gastrointestinal bleeding (GIB) and diverticular inflammation (diverticulitis). A40-year old male presented to the emergency department with a one-day history of acute, severe abdominal pain. His physical examination revealed a remarkable abdominal tenderness. An abdominal CT scan exhibited a distal small bowel obstruction with "whirlpool sign," dilation of proximal small bowel loops and a thickened proximal appendix. An emergency diagnostic laparoscopy was performed revealing an axial torsion of a large MD measuring approximately 15 cm. Meckel's diverticulectomy was performed. The patient was discharged on the 3rd postoperative day with an uneventful follow-up. We highlight the importance of emergency diagnosis of a complicated MD in the case of right lower quadrant abdominal pain in the adult patient.