Axial Torsion of a Necrotic Giant Meckel's Diverticulum With Secondary Peritonitis in a 7-Year-Old: A Case Report.

Axial torsion with subsequent gangrene of Meckel's diverticulum represents an exceptionally rare cause of small bowel obstruction, one of the rarest causes of small bowel obstruction. Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract, and it is often discovered incidentally during abdominal surgery, particularly in pediatric patients. Approximately 4% of individuals with Meckel's diverticulum develop complications, including bleeding, obstruction, inflammation, intussusception, or perforation, with torsion being the rarest. Despite its rarity, symptomatic Meckel's diverticulum poses serious diagnostic and therapeutic challenges due to its nonspecific clinical presentation, which may mimic other intra-abdominal pathologies. Consequently, preoperative diagnosis is difficult, and delayed management may lead to life-threatening complications. We report a case of axial gangrenous torsion of a giant Meckel's diverticulum in a child without a history of previous abdominal surgery. In such cases, prompt decision-making for exploratory laparotomy or laparoscopy is crucial to achieving a favorable outcome. We report a case of axial torsion with gangrene of a giant Meckel's diverticulum in a 7-year-old boy with no prior history of abdominal surgery. This case highlights the importance of early recognition and timely operative management in atypical presentations of acute abdomen in children.