Meckel’s diverticulum is the most common congenital anomaly of the gastrointestinal tract. The anatomy of Meckel’s diverticulum varies, and when it is attached to the abdominal wall or mesentery by means of fibrous cords, it can cause obstruction including massive bowel gangrene which has not yet been reported in the literature. A middle-aged man presented to the emergency wing with a history of obstipation and vomiting for 2 days. A CECT (Contrast Enhanced Computed Tomography) abdomen revealed dilated ileal bowel loops with multiple strictures, mesenteric lymph nodes, and mild ascites. With a provisional diagnosis of tuberculosis of the abdomen, he was taken for emergency laparotomy. Around 200 cm of distal ileum was found gangrenous due to the herniation of it beneath a mesodiverticular band which was connected to the apex of Meckel’s diverticulum found 50 cm from the ileocolic junction. The gangrenous bowel along with the gangrenous Meckel’s diverticulum was resected, and an end ileostomy and distal mucosal fistula were made. Meckel’s diverticulum must be kept as a differential in any young patients presenting with acute intestinal obstruction with no previous history of abdominal surgery, TB abdomen, or inflammatory bowel disease. While recommendations suggest resection of symptomatic Meckel’s diverticulum with a narrow base and wide body due to its propensity to rotate along its axis and cause gangrene of Meckel’s diverticulum, we believe Meckel’s diverticulum with a band attaching it to umbilicus or with ileal mesentery must be considered for resection to prevent grave complications.

梅克尔憩室是最常见的胃肠道先天性异常。梅克尔憩室的解剖结构各异，当其通过纤维索附着于腹壁或肠系膜时，可引起梗阻，包括大片肠坏疽，目前尚未有文献报道。一名中年男子因便秘和呕吐病史 2 天被送往急诊室。腹部 CECT（对比增强计算机断层扫描）显示回肠肠袢扩张，伴有多处狭窄、肠系膜淋巴结和轻度腹水。初步诊断为腹部结核，他被送往紧急剖腹手术。回肠远端约 200 厘米被发现坏疽，因为它在中憩室带下方突出，该带与距回结肠交界处 50 厘米的梅克尔憩室顶端相连。切除坏疽肠和坏疽梅克尔憩室，并进行末端回肠造口和远端粘膜瘘。对于任何患有急性肠梗阻且既往没有腹部手术史、腹部结核或炎症性肠病史的年轻患者，必须将梅克尔憩室作为鉴别诊断。虽然建议建议切除具有狭窄基底和宽体的症状性梅克尔憩室，因为其倾向于沿其轴线旋转并导致梅克尔憩室坏疽，但我们认为必须考虑用带子将其连接到脐部或具有回肠系膜的梅克尔憩室切除以防止严重并发症。