THREE CASES OF MECKEL'S DIVERTICULUM PRESENTING WITH STRANGULATION OF SMALL INTESTINE

We experienced three cases of Meckel's diverticulum presenting with strangulation of small intestine. Case 1: A 7-year-old boy. There was a previous history of undergoing appendectomy at the age of six. The patient was admitted to the hospital because of abrupt onset of abdominal pain and vomiting. Conservative treatment was ineffective and laparotomy was carried out on the 5th hospital day. It was found that he had a volvulus caused by Meckel's diverticulum and vitteline cyst which is a rare entiry. Case 2: A 83-year-old man. There was a previous history of undergoing appendectomy at the age of 40. The patient was admitted to the hospital because of nausea. he did not respond to the conservative treatment using an ileus tube. Laparotomy was performed on the 9th hospital day. It disclosed strangulation and necrosis of a segment of the ileum resulting from the adhesive band formed by Meckel's diverticulitis. Case 3: A 76-year-old man. There was a previous history of undergoing gastrectomy when he was 56 years old. The patient had repeated abdominal pain, nausea, and vomiting for about one month. These symptoms became worse since 2 days before. So laparotomy was carried out. During surgery, Meckel's diverticulum adhered to the transverse colon and strangulation of the ileum was present. All three cases had a previous history of undergoing laparotomy. It was difficult to make preoperative diagnosis of intestinal obstruction caused by Meckel's diverticulum, because their symptoms often justify to select the conservative therapy under a diagnosis of adhesive ileus.