Gangrenous Meckel’s diverticulum due to axial torsion around a mesodiverticular band: A rare cause of acute abdomen in adults

Abstract Meckel’s diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract, though it rarely presents with complications in adulthood. Axial torsion leading to gangrene, especially due to a mesodiverticular band, is an uncommon presentation and may pose a diagnostic challenge. We report a case of a 58-year-old female who presented with acute intestinal obstruction. Diagnostic laparoscopy revealed a gangrenous MD caused by axial rotation around a mesodiverticular band, without involvement of the adjacent ileum. Laparoscopic diverticulectomy was successfully performed. Isolated torsion of the MD is rare, particularly in adults. A mesodiverticular band can predispose to isolated volvulus, ischaemia and gangrene. Early surgical intervention is essential to prevent morbidity, and complicated MD in adults is often misdiagnosed. A high index of suspicion should be maintained in cases of intestinal obstruction with atypical features. This case highlights the importance of early laparoscopic evaluation in adults presenting with unexplained obstruction.