| Summary: | Introduction. Meckel’s diverticulum (MD) is the most prevalent congenital
anomaly of small intestine. It develops due to the incomplete obliteration of
omphalomesenterict duct which normally undergoes obliteration during the
seventh week of gestation. In the majority of cases MD is asymptomatic but it
may cause various complications, such as bleeding, intestinal obstruction and
inflammation. Cases of umbilical sinuses, fistulas and neoplasms related with
MD have been reported, but extremely rare gangrene due to its axial torsion,
especially in children, as is the case of our patients. Case Outline. An
11-year-old boy admitted to hospital due to 24 hours epigastric pain,
vomiting and malaise. After a complete physical examination, and appropriate
pre-surgical laboratory and radiographic tests, surgical exploration was
performed with a midline abdominal incision. On 60th cm proximal to the
ileocecal valve we found a long and in a narrow based ganrenous MD with axial
torsion and fibrotic cord extending from the tip of MD to the ileal
mesentery. Surrounding ileum had normal appearance. A demarcation and
subsequent resection of MD and the surrounding ileum was performed with
endto- end ileal anastomosis. Postoperative recovery was successful and the
patient was discharged after six days. Conclusion. Axial torsion of MD is
presented with non-specific abdominal symptoms and difficult preoperative
diagnosis. The choice of diagnosis and therapy is surgical exploration and
resection of MD.
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