title: Acute appendicitis with unusual dual pathology.
abstract: BACKGROUND
  Meckel's diverticulum is a rare congenital abnormality arising due to the persistence of the vitelline duct in 1-3% of the population. Clinical presentation is varied and includes rectal bleeding, intestinal obstruction, diverticulitis and ulceration; therefore diagnosis can be difficult.
  
  
  METHODS
  We report a case of acute appendicitis complicated by persistent post operative small bowel obstruction. Further surgical examination of the bowel revealed an non-inflamed, inverted Meckel's diverticulum causing intussusception.
  
  
  CONCLUSIONS
  Intestinal obstruction in patients with Meckel's diverticulum may be caused by volvulus, intussusception or incarceration of the diverticulum into a hernia. Obstruction secondary to intussusception is relatively uncommon and frequently leads to a confusing and complicated clinical picture.
  
  
  CONCLUSIONS
  Consideration of Meckel's diverticulum although a rare diagnosis is imperative and this case raises the question "should surgeons routinely examine the bowel for Meckel's diverticulum at laparoscopy?"
authors.affiliation: Department of Vascular Surgery, Northampton General Hospital, Cliftonville, Northampton NN1 5BD, United Kingdom.
authors.forename: Georgina E
authors.initials: GE
authors.lastname: Riddiough
authors.forename: Imran
authors.initials: I
authors.lastname: Bhatti
authors.forename: David A
authors.initials: DA
authors.lastname: Ratliff