Abstract
INTRODUCTION: Meckel's diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract, occurring in approximately 2 % of the population. While often asymptomatic, MD can occasionally lead to complications such as bleeding, inflammation, or small bowel obstruction (SBO). A rare cause of SBO involves a mesodiverticular band, an embryologic remnant capable of causing extrinsic compression or torsion. This condition remains under-recognized, especially in adolescents. CASE PRESENTATION: A 15-year-old male presented with acute abdominal pain, vomiting, and clinical signs of small bowel obstruction (SBO). Abdominal ultrasound and computed tomography (CT) revealed dilated small bowel loops with a distal transition point. CT imaging confirmed Meckel's diverticulitis in the right iliac fossa, associated with a mesodiverticular band, which was identified as the cause of the small bowel obstruction. Diagnostic laparoscopy confirmed the presence of a Meckel's diverticulitis with an associated mesodiverticular band causing torsion and obstruction. The band was divided with a harmonic scalpel, and the gangrenous diverticulum was resected laparoscopically using a linear endostapler. An appendectomy was also performed concurrently. The procedure was completed successfully without complications, and the patient was discharged in stable condition on postoperative day three. DISCUSSION: Mesodiverticular bands are an uncommon but important etiology of small bowel obstruction in pediatric and adolescent patients. Their diagnosis is often delayed due to non-specific clinical and radiologic findings. Laparoscopy provides a dual benefit in such cases, allowing both definitive diagnosis and minimally invasive treatment with reduced morbidity. CONCLUSION: This case underscores the need to consider Meckel's diverticulum and its associated bands in the differential diagnosis of SBO. Early laparoscopic intervention is both safe and effective, ensuring excellent outcomes.