Meckel's Diverticulitis Associated with Acute Gastroenteritis: A Rare Cause of Ileus

Meckel's diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract, occurring in 2-3% of the population. Only 2% of patients with MD manifest clinical problems. Diverticulitis occurs in approximately 10-20% of patients with symptomatic MD and more often in the elderly population. This anomaly is due to the incomplete obliteration of the omphalomesenteric duct during the seventh week of gestation and is classically located two feet proximal to the ileocaecal valve. While most of the population may be asymptomatic, clinical manifestation, including gastrointestinal bleeding and intestinal obstruction, may be present. We present the case of a 22 year old man who presented with a 24 hour history of worsening abdominal pain and nausea with a history of gastroenteritis. His examination revealed lower abdominal peritonitis. An abdominal ultrasonography revealed a tubular structure with 16 mm transverse diameter in the right lower abdomen adjacent to the distal small bowel. Exploratory laparotomy was performed, which revealed an acutely inflamed Meckel's diverticulitis causing ileus. Consideration of this condition in the differential upon presentation of an acute abdomen and obstruction of the gastrointestinal tract is essential, secondary to the morbidity that can accompany this condition when misdiagnosed.