G. Devanaboyna, MB BS, D. Singh-

with interest, and wewould like to add to their series by de-scribing the phenomenon of small bowelobstruction secondary to an adhesionfrom the distal end of a Meckel’s diver-ticulum. The adhesion formed a bandthat trapped a loop of ileum.The case in question involved a fitgentleman, aged 33 years, who had re-ceived a few blows to the abdomen dur-ing a martial arts lesson. Twelve hourslater, he began experiencing periumbili-cal colic, nausea and vomiting, with ab-solute constipation. He did not thinkthat the symptoms were due to the in-juries sustained to his abdomen; he hadexperienced these before and had notthought that they were too severe.Clinical examination revealed a dis-tended abdomen that was tender butnot peritonitic. Bowel sounds were rapidand tinkling. An abdominal radiographshowed dilated loops of small bowel inthe left upper quadrant and no air in therectum. There was no pyrexia or leuco-cytosis.At emergency laparotomy, the proxi-mal small bowel was grossly dilated withevidence of 2 serosal tears. A Meckel’sdiverticulum was discovered that had aninflamed and abnormal looking distalend. An adhesion was attached to thisend and the antimesenteric border of theterminal ileum. A collapsed segment ofproximal terminal ileum was trappedwithin the loop created by the adhesion.The Meckel’s diverticulum and adhesionwere excised with a 35-mm translinearcutting stapling device. The small bowelwas decompressed with the use of a suc-tion device modelled on the Savagesucker. The gentleman made a good post-operative recovery and was discharged7 days after surgery.A review of the literature shows onlyone other case report that describes asimilar intraoperative finding.