Meckel’s diverticulum is the most prevalent congenital malformation of the gastrointestinal tract. However, the coexistence of double Meckel’s diverticula and a mobile cecum is rare and has rarely been reported in the literature. A 40-year-old male presented with melena, and his condition subsequently deteriorated, with a blood pressure of 73/57 mmHg and a heart rate of 56 beats/min. Contrast-enhanced computed tomography revealed a giant blind lumen filled with hematoma and malposition of the right colon. The patient underwent an emergency surgery. Although a smaller diverticulum was initially found via minilaparotomy, the discrepancy with preoperative imaging prompted further laparoscopic exploration, which revealed a second large diverticulum measuring 170 mm. Both diverticula were resected. Pathological examination revealed that the smaller diverticulum contained ectopic duodenal and gastric mucosa, whereas the larger diverticulum contained ectopic gastric mucosa and pancreatic tissue. The coexistence of double Meckel’s diverticula and a mobile cecum is a rare anomaly. Although life-threatening hemorrhage from a Meckel's diverticulum is an uncommon presentation in adults, this case highlights the critical need to thoroughly explore for additional lesions when intraoperative findings do not fully align with preoperative imaging. Furthermore, surgical strategies must be tailored to the specific morphology of each diverticulum.
Okumura et al. (Thu,) studied this question.