A Case of Ileus Caused by an Internal Hernia Through a Direct Adhesion between the Tip of the Appendix and Meckel's Diverticulum

Hideo Matsubara, Akihiro Hori, Yosuke Yamaguchi, Naoki Sawasaki, Yosuke Okada, Hiroshi Kaito¹⁾ and Takahiko Seo²⁾

Department of Surgery and Department of Pathology¹⁾, The Gifu Prefectural Federation of Agricultural Cooperatives for Health and Welfare Kumiai Hospital
Department of Pediatric Surgery, Nagoya University, School of Medicine²⁾

A 84-year-old man had nausea and stomach fullness in early January 2003. He was diagnosed as having ileus by a neighborhood clinic and was referred to our hospital. He had no history of abdominal surgery. Because his abdominal pain was not severe, we started long tube conservative therapy. After 3 days, the ileus was relieved. Radiographic small bowel examination with contrast medium revealed no obstruction of the intestine, but there was a diverticulum in the small bowel. Meckel's diverticulum was suspected. The patient developed ileus again in the middle of January, 2003 and we decided to operate. During the operation, we found an adhesion of the appendix and the apex of Meckel's diverticulum. The small bowel was obstructed by an internal hernia through the adhesion. There was no necrosis in the small bowel and we resected the appendix and the Meckel's diverticulum. The patient's post operative course was uneventful and he left our hospital 11 days after the operation.

Key words
ileus, Meckel's diverticulum, appendix

Reprint requests
Hideo Matsubara Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine
65 Tsurumai-chyo, Showa-ku, Nagoya, 466-8550 JAPAN

Accepted
June 22, 2005

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