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Arch Surg. 2007;142(5):486.

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Answer: Internal Hernia

In the left iliac fossa, a Meckel diverticulum was identified. Its tip was adherent to the retroperitoneum. A segment of terminal ileum had herniated through the loop formed by the diverticulum, retroperitoneum, and adjacent bowel. Subsequently, it had become incarcerated and obstructed, resulting in gross dilation of the proximal small bowel. The Meckel diverticulum itself had perforated at its base. The affected segment of ileum was resected with the perforated Meckel diverticulum. Histological analysis confirmed the diagnosis of Meckel diverticulum containing ectopic gastric mucosa. The peritoneal cavity was thoroughly irrigated. Finally, a temporary double-barrel ileostomy was made. The patient had a good and uneventful recovery.

Meckel diverticulum is the most common congenital gastrointestinal malformation; it is found in up to 2% of the population.¹ It is the remnant of the vitellointestinal tract, which disappears in the fifth to sixth week of gestation. The diverticulum is classically located 2 ft (60 . . . [Full Text of this Article]

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Arch Surg. 2007;142(5):485.
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