EP 552 A Mesenteric Sided Meckel’s Diverticulum – A Case Report of a Rare and Unexpected Intraoperative Finding

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ID: 323869
2026
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Abstract
Abstract Background Meckel’s diverticulum is a congenital anomaly found in 2% of the population, classically located on the anti-mesenteric side of the distal ileum. Only 13 cases of Meckel’s diverticula have been reported on the mesenteric aspect of the ileum in the last decade. Methods We report a rare case of an anatomical variant of Meckel’s diverticulum located on the mesenteric side of the distal ileum, in a 21-year-old male. The patient presented with central abdominal pain, nausea & vomiting. There was right iliac fossa and suprapubic tenderness with guarding on exam. Results Laboratory findings showed white cell count 23.5×109/L, haemoglobin 14.1mmol/L, and C-reactive protein 261mmol/L. CT abdomen/pelvis reported a “focal inflammatory process in the right lower quadrant, with multiple inflamed loops of small bowel, which are centred on what appears to be a blind ending tubular structure with a radiopaque fecaliths at its base. Appearances are concerning for Meckel's diverticulitis”. Laparoscopy revealed a large phlegmonous mass in the pelvis. The operation was converted to an open laparotomy and a segmental resection of the diverticulum with side-to-side stapled anastomosis was performed. The anomalous location of the diverticulum, on the mesenteric side of the distal ileum, was recognised intraoperatively. Conclusion Only 13 cases of mesenteric-sided Meckel’s Diverticulua have been reported in the literature in the last decade. Given its proximity to the mesenteric vasculature, there an increased risk of bleeding, thrombosis, obstruction, and ultimately perforation. Due to the risk of complications, mesenteric-sided Meckel’s Diverticulum requires segmental resection with primary anastomosis.
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Authors Conor Kearns, Angus Lloyd, Meghan Jaden Wootton, Colm Power
Journal the british journal of surgery
Year 2026
DOI
10.1093/bjs/znag087.621
URL
https://doi.org/10.1093/bjs/znag087.621
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