Incomplete common mesentery with Ladd's band and Meckel's diverticulum: A rare cause of small bowel obstruction.

Autor:	Jabra SB; Department of Visceral and Digestive Surgery, Monastir University Hospital, Tunisia., Chaouch MA; Department of Visceral and Digestive Surgery, Monastir University Hospital, Tunisia. Electronic address: Docmedalichaouch@gmail.com., Moussa A; Department of Visceral and Digestive Surgery, Monastir University Hospital, Tunisia., Jallali M; Department of Visceral and Digestive Surgery, Monastir University Hospital, Tunisia., Toumi O; Department of Visceral and Digestive Surgery, Monastir University Hospital, Tunisia., Noomen F; Department of Visceral and Digestive Surgery, Monastir University Hospital, Tunisia.
Jazyk:	angličtina
Zdroj:	International journal of surgery case reports [Int J Surg Case Rep] 2023 May; Vol. 106, pp. 108159. Date of Electronic Publication: 2023 Apr 11.
DOI:	10.1016/j.ijscr.2023.108159
Abstrakt:	Introduction and Importance: The common mesentery is an abnormal rotation of the primitive intestinal loop or omphalomesenteric loop. It is not necessarily symptomatic, but a clinical presentation of acute bowel obstruction on the band or volvulus can reveal it. We report a case of small bowel obstruction due to Ladd's band and Meckel's diverticulum on the incomplete common mesentery. Presentation of Case: We report a case of a 54-year-old man with no previous abdominal surgery who experienced periumbilical abdominal pain and vomiting. Physical examination revealed a diffusely tender and distended abdomen. Laboratory data showed a biological inflammatory syndrome. An abdominal CT scan revealed a small bowel mechanical obstruction with a double transitional level under the umbilical without a loop enhancement. An emergent laparotomy was performed. We found an incomplete common mesentery. The small bowel obstruction was due to a Ladd's band attrapping the Meckel's diverticulum. This association was responsible for dilating ileal loops at the superior part of the mechanical obstruction with necrosis of 30 cm of the small bowel. We have sectioned the congenital band and resected the necrotic segment, followed by an intestinal anastomosis. The postoperative follow-up was uneventful. Clinical Discussion: Incomplete common mesentery with Ladd's band and Meckel's diverticulum is an extremely rare association. Causing a small bowel obstruction remains an uncommon complication and circumstance of discovery. This complication presents a life-threatening condition. An abdominal CT scan could help for the diagnosis in some cases. Surgery is the standard treatment in most cases. Conclusion: The association of incomplete common mesentery with Ladd's band and Meckel's diverticulum is uncommon and should be known to avoid intraoperative misdiagnose. Competing Interests: Conflict of interest statement None. (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
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