title: Strangulated internal hernia by giant Meckel diverticulum presented as acute appendicitis.
abstract: BACKGROUND
  Internal hernia due to a Meckel diverticulum is a common presentation of bowel obstruction mostly seen in pediatric population. However, it has been stated that among 5% of the patients had a giant Meckel diverticulum (defined as a Meckel diverticulum with increased dimensions than the ones commonly found), being this condition very unusual.
  
  
  METHODS
  We presented a 19 year old male with acute abdominal pain suggestive of appendicitis. During appendectomy we discovered ischemic and necrotic signs in a bowel segment, leading us to perform a laparotomy that revealed a portion of ischemic and necrotic jejunum, and another bowel segment with a strong adherence to the mesentery root that created an internal hernia. The internal hernia was reduced and the injured bowel portions were resected. Necrotic bowel samples were sent to the pathology department who posteriorly reported a giant Meckel diverticulum. The patient had an excellent recovery after procedure.
  
  
  CONCLUSIONS
  After searching in PubMed for a similar association between Meckel diverticulum and internal hernia, we found few cases that reported a giant Meckel diverticulum and a low occurrence with internal hernias making our case not so common to find.
  
  
  CONCLUSIONS
  We concluded that a giant Meckel diverticulum in association with mesenteric defects producing internal hernias are not common pathologies to find together in a patient as our research and case suggest.
authors.affiliation: MD, FACS - ASURG, Carrera 14A #151A-39 Bogotá, Colombia; Department of Surgery Hospital de Fontibón, Carrera 99 #16i-41, Bogotá, Colombia. Electronic address: fuentesjhonny@unbosque.edu.co.
authors.forename: Jhonny Mauricio
authors.initials: JM
authors.lastname: Fuentes-Diaz
authors.affiliation: MD, ASURG Research, Carrera 14A #151A-39 Bogotá, Colombia. Electronic address: ca.trujillo950@uniandes.edu.co.
authors.forename: Camilo Andrés
authors.initials: CA
authors.lastname: Trujillo-Vasquez
authors.affiliation: MD, ASURG Clinical Research, Carrera 14A #151A-39 Bogotá, Colombia. Electronic address: anap22@hotmail.com.
authors.forename: Ana María
authors.initials: AM
authors.lastname: Parra-Vargas
authors.affiliation: MD, ASURG Public Health Research, Carrera 14A #151A-39 Bogotá, Colombia. Electronic address: andresofy@gmail.com.
authors.forename: Andrea Sofía
authors.initials: AS
authors.lastname: Rovira-Chaves
authors.affiliation: MD, ASURG Clinical Research, Carrera 14A #151A-39 Bogotá, Colombia. Electronic address: girlaura88@hotmail.com.
authors.forename: Laura Viviana
authors.initials: LV
authors.lastname: Tinoco-Guzman
authors.affiliation: MD, ASURG Clinical Research, Carrera 14A #151A-39 Bogotá, Colombia. Electronic address: marce767@hotmail.com.
authors.forename: Johana Marcela
authors.initials: JM
authors.lastname: Garcia-Garcia
keywords: Appendicitis; Giant Meckel diverticulum; Internal hernia