Abstract
Small bowel obstruction (SBO) remains the most common diagnosis encountered by general surgeons, with 70% of cases related to adhesions from previous abdominal surgeries. Less common etiologies include Crohn's disease, gallstone ileus, and Meckel's diverticulum (MD). While MD is the most common congenital anomaly of the gastrointestinal tract, it is less frequently considered as a cause in adults. Nonetheless, it remains crucial to consider MD as a potential cause of SBO in adults, especially when evaluating patients with unexplained SBO and recurrent idiopathic abdominal pain, especially in those without a history of abdominal surgery. We present a case of a 74-year-old male presenting with right upper quadrant abdominal pain, constipation, and bilious vomiting, with a presumed diagnosis of SBO and perforation, potentially attributed to MD. This case highlights the differential challenges posed by small bowel diverticula and their complications, underscoring the need for vigilance in recognizing these complications and optimizing clinical management.