Meckel's Diverticulum-Induced Intussusception Coinciding with Diabetes Mellitus in a Young Adult Male: A Rare Case Study

Reza Aditya Digambiro; Edy  Parwanto; Dyah Ayu Woro Setianingrum; Florinda  Ilona; Indah Widya   Lestari; Julian  Chendrasari

doi:10.36452/jkdoktmeditek.v31i1.3084

Authors

Reza Aditya Digambiro Faculty of Medicine, Trisakti University, Jakarta, Indonesia
Edy Parwanto Faculty of Medicine, Trisakti University, Jakarta, Indonesia
Dyah Ayu Woro Setianingrum Faculty of Medicine, Trisakti University, Jakarta, Indonesia
Florinda Ilona Faculty of Medicine, Trisakti University, Jakarta, Indonesia
Indah Widya Lestari Faculty of Medicine, Trisakti University, Jakarta, Indonesia
Julian Chendrasari Faculty of Medicine, Trisakti University, Jakarta, Indonesia

DOI:

https://doi.org/10.36452/jkdoktmeditek.v31i1.3084

Keywords:

adult intussusception, ileo-ileal intussusception, meckel's diverticulum

Abstract

Introduction: Intussusception in adults, especially when caused by Meckel's Diverticulum, is a rare occurrence, often presenting with nonspecific symptoms such as abdominal pain and nausea, making it challenging to diagnose. When concurrent with conditions like diabetes mellitus, the situation need particular care. Case Illustration: A 27-year-old male with a medical history of diabetes presented with severe right abdominal pain, nausea, and a reduced appetite. Initial symptomatic treatment did not alleviate the condition. Subsequent CT scans revealed an ileo-ileal intussusception triggered by Meckel's Diverticulum and partial high obstruction ileus, leading to surgical intervention. Discussion: Ileo-ileal resection (end to end anastomosis) and adhesiolysis surgery were successfully performed, followed by vigilant postoperative monitoring for complications, effective pain management, maintenance of drain patency, and careful glucose level monitoring. The patient's significant postoperative improvement underscores the importance of early diagnosis and timely surgical intervention in managing Meckel's Diverticulum-induced intussusception in adults. Conclusion: The clinical course also highlighted the importance of tailoring postoperative care considering the patient's comorbidities, in this case, diabetes mellitus. This case served as a reminder for clinicians to consider Meckel's Diverticulum as a potential cause of intussusception in adults presenting with abdominal pain.

Author Biography

Reza Aditya Digambiro, Faculty of Medicine, Trisakti University, Jakarta, Indonesia

Head of Pathology Department

References

Falousse K, Hajri A, Bouali M, El-Bakouri A, El-Hattabi K, Bensardi FZ, et al. Ileo-ileal intussusception secondary to Meckel’s diverticulum. Int J Clin Stud Med Case Rep. 2024;33(4). doi:10.46998/IJCMCR.2023.33.000819.

Marsicovetere P, Ivatury SJ, White B, Holubar SD. Intestinal intussusception: etiology, diagnosis, and treatment. Clin Colon Rectal Surg. 2017 Feb 1;30(1):030–9.

Tarchouli M, Ait Ali A. Adult intussusception: an uncommon condition and challenging management. Visc Med. 2021 Mar 1;37(2):120–7.

Du YT, Rayner CK, Jones KL, Talley NJ, Horowitz M. Gastrointestinal symptoms in diabetes: prevalence, assessment, pathogenesis, and management. Diabetes Care. 2018 Mar 1;41(3):627–37.

Garg D, Singh AP, Kothari S, Kumar A. Urachal cyst, Meckel’s diverticulum and band, and urachus. APSP J Case Rep. 2017 Jan 4;8(1):8.

An J, Zabbo CP. Meckel Diverticulum. [Updated 2023 Jan 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499960/vglJ.

Hartman MS, Daffner RH. Abdominal radiographs. In: Daffner RH, editor. Clinical radiology: the essentials. Wolters Kluwer Health; 2013. p. 215–51.

Oakland K, Chadwick G, East JE, Guy R, Humphries A, Jairath V, et al. Diagnosis and management of acute lower gastrointestinal bleeding: guidelines from the British Society of Gastroenterology. Gut. 2019 Feb 12;68(5):776–89.

Elimeleh Y, Gralnek IM. Diagnosis and management of acute lower gastrointestinal bleeding. Vol. 40, Current Opinion in Gastroenterology. Lippincott Williams and Wilkins; 2024. p. 34–42.

Umar D. MRI vs. CT scan: a comparative study in radiology diagnosis [Internet]. Available from: https://www.researchgate.net/publication/370756904

Kanamori K, Koyanagi K, Hara H, Nakamura K, Nabeshima K, Yamamoto M, et al. Small bowel obstruction caused by a true ileo-ileal knot: a rare case successfully treated by prior ligation of mesenteric vessels. Surg Case Rep. 2021 Dec;7(1).

Yusuf S, Liansyah TM. Pediatric ileocolica invagination: a case report. Britain International of Exact Sciences (BIoEx) Journal. 2020 Sep 12;2(3):615–9.

Craciun CI, Neag MA, Catinean A, Mitre AO, Rusu A, Bala C, et al. The relationships between gut microbiota and diabetes mellitus, and treatments for diabetes mellitus. Vol. 10, Biomedicines. MDPI; 2022.

Yan P, Jiang S. Tc-99m scan for pediatric bleeding Meckel diverticulum:a systematic review and meta-analysis. Vol. 99, Jornal de Pediatria. Elsevier Editora Ltda; 2023. p. 425–31.

Bestari L, Ismianti. Characteristics of patients with type 2 diabetes mellitus at Surabaya Haji General Hospital. The Indonesian Journal of Public Health. 2020;15(3):286–94. Available from: http://localhost:8080/xmlui/handle/123456789/4098.

Ishaq S, Siau K, Lee M, Sultan H, Mohaghegh SH, Kuwai T, et al. Long-term success of flexible endoscopic septal division with the stag beetle knife for Zenker's diverticulum: a tertiary center study. Dis Esophagus. 2020 Nov 18;33(11):doaa019. doi: 10.1093/dote/doaa019. PMID: 32266391.

Behr HH, Kulaçatan M. DITIB Jugendstudie 2021: Lebensweltliche Einstellungen junger Muslim:innen in Deutschland. Weinheim; Basel: Beltz Juventa; 2022. 185 p. (Jugendforschung). doi:10.25656/01:28906. Available from: https://nbn-resolving.org/urn:nbn:de:0111-pedocs-289061.

Luzzi S, Giotta-Lucifero A Galzio R. Comparative analysis of surgical working corridors for Meckel cave trigeminal schwannomas. Abstract in Proceedings of the Conference on Surgical Corridors, January 1, 2024. Available from: https://hdl.handle.net/11571/1490857.

Yépez-Yerovi FE, Carranza-Sánchez AN. Rare case of intestinal obstruction due to volvulus of the terminal ileum by Meckel's diverticulum in an elderly patient. Pol Conoc [Internet]. 2022 Jun;7(6):626–39. doi:10.23857/pc.v7i6.4095. Available from: http://polodelconocimiento.com/ojs/index.php/e.

Kuru S, Kismet K. Meckel’s diverticulum: clinical features, diagnosis and management. Revista Espanola de Enfermedades Digestivas. 2018;110(11):726–32.