Abstract
INTRODUCTION: Meckel's diverticulum (MD) is a congenital anomaly of the gastrointestinal tract that occurs in approximately 2% of the population. While often asymptomatic, it can present with complications such as gastrointestinal bleeding, inflammation, or intestinal obstruction. The coexistence of MD with acute appendicitis is exceedingly rare and poses significant diagnostic and therapeutic challenges. CASE PRESENTATION: We report the case of a 15-year-old male who presented with severe abdominal pain, nausea, vomiting, constipation, and fever. Clinical examination revealed a distended and tender abdomen with marked paraumbilical and right iliac fossa tenderness. Imaging studies indicated features of intestinal obstruction. During exploratory laparotomy, a Meckel's diverticulum tethered to the umbilicus by a fibrous band was identified, with the ileum twisted around the band causing an obstruction. Additionally, acute appendicitis with pelvic pus was discovered. Surgical management involved division of the fibrous band, wedge resection of the Meckel's diverticulum, and appendectomy. The patient had an uneventful recovery and was discharged on the fifth postoperative day. DISCUSSION: This case highlights the rare presentation of concurrent Meckel's diverticulum-associated small bowel obstruction and acute appendicitis. It underscores the importance of maintaining a high index of suspicion for multiple abdominal pathologies in patients presenting with acute abdomen. Prompt diagnosis and surgical intervention are critical to achieving favorable outcomes in such complex cases. CONCLUSION: This case emphasizes the diagnostic and management challenges of concurrent abdominal pathologies and provides valuable insights into the surgical approach for such rare clinical scenarios.