eP185 A case report and literature review of Ischaemic Meckel’s Diverticulum, Mesodiverticular Band, and Small Bowel Volvulus with Closed Loop Obstruction

Aims Meckel’s diverticulum (MD), the most common congenital anomaly of the gastrointestinal tract, can present with rare but severe complications like obstruction and ischemia. This report aims to highlight the importance of early laparoscopic intervention in cases of small bowel obstruction (SBO) due to MD and associated mesodiverticular band (MDB). Methods A 12-year-old male presented with acute abdominal pain, vomiting, and diarrhoea. Clinical evaluation indicated acute appendicitis, prompting emergency diagnostic laparoscopy. Intraoperatively, an ischemic MD with an MDB causing a closed-loop SBO was identified. The MDB was divided, the small bowel untwisted, and the MD excised laparoscopically. A literature review of 16 reported cases of MDB-related SBO from the past five years was conducted for comparative analysis. Results The patient’s postoperative recovery was uneventful, with discharge on day four. Histology confirmed infarcted MD without malignancy. Compared to reviewed cases, this case had the shortest time from admission to surgery (4 hours) and no ischemic bowel or resection required. Laparoscopic management was associated with reduced postoperative stay (average 4 days) and no complications, contrasting with higher ischemia rates and longer stays in laparotomy cases. Conclusion MDB-related SBO is rare but requires urgent surgical intervention to prevent ischemia. This case underscores the diagnostic and therapeutic advantages of laparoscopy, enabling minimally invasive management with shorter recovery times and favorable outcomes compared to laparotomy. Prompt diagnosis and early surgical intervention are critical for optimal patient outcomes.