Concurrent Meckel's Diverticulum and Sjögren Syndrome: A Case of Intestinal Obstruction.

Abstract

BACKGROUND Meckel's diverticulum is a congenital diverticulum that contains all normal layers of the gastrointestinal wall. In adults, Meckel's diverticulum can present with bowel obstruction, the most common presentation, in 35.6% of cases. In addition, complicated Meckel's diverticulum can present with small bowel obstruction. Sjögren syndrome is a rare systemic autoimmune disorder. The theory behind Sjögren syndrome is that lymphocyte-rich mononuclear cell foci infiltrate exocrine glandular tissue, and humoral factors, such as antibodies and cytokines, cause dysfunction to the exocrine glands, leading to diminished saliva and tear production and skin, tracheobronchial, and vaginal dryness. Sjögren syndrome can present with intestinal pseudo-obstruction as a rare complication. CASE REPORT A 25-year-old woman with a known case of Sjögren syndrome presented to the Emergency Department with abdominal pain. Laboratory investigations were sent, and all results were within reference values. Multiple imaging studies were done, and findings indicated the presence of ileus, rather than bowel, obstruction. Consequently, she was admitted under general surgery, and laparoscopic exploration was done, which showed Meckel's diverticulum. The patient was discharged home in a stable state. Two weeks later, a colonoscopy was done, showing a normal study. CONCLUSIONS It is important to consider Meckel's diverticulum as a possible cause of sudden abdominal pain in adults, as it can have catastrophic consequences. Furthermore, studies have shown that Meckel's diverticulum and Sjögren syndrome are distinct entities. Yet, both conditions can present with symptoms of intestinal obstruction.