Acar B, Muhtaroğlu A, Yılmaz E. Giant Meckel’s diverticulum with inflammation, ischemia, and adhesive obstruction: A case report. World J Gastrointest Surg 2026; 18(8): 120717 [DOI: 10.4240/wjgs.120717]
Corresponding Author of This Article
Ali Muhtaroğlu, Associate Professor, Department of General Surgery, Giresun University Faculty of Medicine, Aksu District, Mehmet İzmen Street, Giresun 28100, Türkiye. alimuhtarogluu@gmail.com
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Surgery
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case-report
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Acar B, Muhtaroğlu A, Yılmaz E. Giant Meckel’s diverticulum with inflammation, ischemia, and adhesive obstruction: A case report. World J Gastrointest Surg 2026; 18(8): 120717 [DOI: 10.4240/wjgs.120717]
World J Gastrointest Surg. Aug 27, 2026; 18(8): 120717 Published online Aug 27, 2026. doi: 10.4240/wjgs.120717
Giant Meckel’s diverticulum with inflammation, ischemia, and adhesive obstruction: A case report
Berkan Acar, Ali Muhtaroğlu, Elif Yılmaz
Berkan Acar, Ali Muhtaroğlu, Department of General Surgery, Giresun University Faculty of Medicine, Giresun 28100, Türkiye
Elif Yılmaz, Department of General Surgery, Private Umut Hospital, Ordu 52100, Türkiye
Author contributions: Muhtaroğlu A conceived the study and drafted the manuscript; Acar B performed the operation and contributed to data interpretation; Yılmaz E collected the clinical data and contributed to critical revision of the manuscript; and all authors read and approved the final manuscript.
AI contribution statement: We used the Grammarly program for language editing. The manuscript content and figures/tables were all created without the use of AI software.
Informed consent statement: The patient provided informed written consent for publication of this case report and the accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Ali Muhtaroğlu, Associate Professor, Department of General Surgery, Giresun University Faculty of Medicine, Aksu District, Mehmet İzmen Street, Giresun 28100, Türkiye. alimuhtarogluu@gmail.com
Received: March 6, 2026 Revised: March 17, 2026 Accepted: April 14, 2026 Published online: August 27, 2026 Processing time: 164 Days and 4.5 Hours
Abstract
BACKGROUND
Adult Meckel diverticulum (MD) is an uncommon cause of acute abdomen, and preoperative diagnosis remains difficult because the presentation overlaps with more familiar right lower quadrant pathology. Giant lesions are particularly rare, with the literature using varying size thresholds. We report a 14-cm MD complicated by inflammation, ischemia, and adhesive small-bowel obstruction in an elderly man.
CASE SUMMARY
A 67-year-old man presented with 3 days of nausea, vomiting, abdominal distension, and obstipation. Laboratory testing showed leukocytosis, elevated inflammatory markers, and dehydration-related renal dysfunction. Contrast-enhanced computed tomography demonstrated diffuse small-bowel dilatation and a blind-ending, inflamed tubular lesion in the right lower quadrant, separate from the cecum. Emergency laparotomy revealed a 14-cm MD arising 50 cm proximal to the ileocecal valve. The diverticulum was distended, ischemic, and densely adherent to adjacent bowel and mesentery, creating a fixed transition point. Adhesiolysis and stapled diverticulectomy were performed. Recovery was uneventful, and the patient was discharged on postoperative day 4. Histopathology showed transmural necrosis, vascular congestion, and acute inflammation without ectopic gastric or pancreatic mucosa.
CONCLUSION
A giant MD should be considered in unexplained adult small-bowel obstruction.
Core Tip: Giant Meckel diverticulum is an unusual but important diagnostic pitfall in adults with small-bowel obstruction. In this case, computed tomography showed a blind-ending, inflamed tubular structure separate from the cecum, and surgery confirmed a 14-cm ischemic diverticulum, with inflammatory adhesions creating the transition point. The case is notable not only for its size but also because severe symptoms developed in the absence of ectopic mucosa, underscoring the role of stasis, ischemia, and adhesion formation in giant lesions.
