title: Meckel's diverticulum mesentery along with its band forming a hernial sac: A rare case of internal herniation.
abstract: BACKGROUND
  Meckel's diverticulum is the most common congenital gastrointestinal anomaly. However, only 2% of cases are symptomatic. It can cause intestinal obstruction by various mechanisms as volvulus, adhesions, Littre's hernia, intussusception.
  
  
  METHODS
  An unusual case of internal herniation of small bowel loops into complete hernia sac formed by unusual mesentery of Meckel's diverticulum which was present upto the adhesive band, extending from tip of the Meckel's diverticulum to the adjacent mesentery of small intestine leading to small bowel obstruction (SBO). Diverticulectomy with resection of adjacent ileum with ileo-ileal anastomosis was done.
  
  
  CONCLUSIONS
  Internal herniation by MD leading to SBO is an extremely rare complication. In literature, cases of internal hernia through mesentry of Meckel's diverticulum, through mesodiverticular band, adhesion of inflamed end of MD to corresponding base of mesentry, fibrous cord extending upto umblical wall have been reported but in our case, patient had both adhesion band along with internal herniation into sac formed by unusual mesentry of the meckel's diverticulum and the adhesion band. Preoperative diagnosis is often difficult with only 6-12% of cases diagnosed correctly. Surgical intervention is indicated for patients with intestinal obstruction or high risk of incarceration.
  
  
  CONCLUSIONS
  Meckel's diverticulum causing internal hernia is rare event. It's presentation due to herniation of bowel loops into sac formed by mesentery attached to diverticulum and the adhesion is rarest, with non specific signs and symptoms. Early diagnosis and prompt treatment prevent further complications.
authors: Department of Surgery, Rajindra Hospital/Government Medical College, Patiala 147001, Punjab, India. Electronic address: drpandovepk@yahoo.co.in.
authors: Paras K
authors: PK
authors: Pandove
authors: Department of Surgery, Rajindra Hospital/Government Medical College, Patiala 147001, Punjab, India.
authors: Ashish
authors: A
authors: Moudgil
authors: Department of Surgery, Rajindra Hospital/Government Medical College, Patiala 147001, Punjab, India.
authors: Megha
authors: M
authors: Pandove
authors: Department of Surgery, Rajindra Hospital/Government Medical College, Patiala 147001, Punjab, India.
authors: Chandrashekhar
authors: Department of Obs & Gynecology Rajindra Hospital Patiala, India.
authors: Divya
authors: D
authors: Sharda
authors: Department of Surgery, Rajindra Hospital/Government Medical College, Patiala 147001, Punjab, India.
authors: Vijay K
authors: VK
authors: Sharda
keywords: Adhesion band; Internal herniation; Meckel’s diverticulum; Mesentery of Meckel’s; Obstruction