Meckel's diverticulum is the most common congenital abnormality of the gastrointestinal tract. It is the common differential diagnosis thought of in cases of lower abdomen pain especially in Appendicitis. When present, Meckel's diverticulum is around 2-5cm and its lifetime risk of complications is approximately 4-6%. Though an entity called 'Giant Meckel's diverticulum' is described in some studies, there are controversies about length or the width of the diverticulum to be considered for calling it a 'giant'. Usually Meckel's diverticulum is directed towards umbilicus or anterior abdominal wall due to its embryological origin. There are various ways of presentation of Meckel's diverticulum and pre-operative diagnosis is difficult except when suspected in cases of bleeding, or when ectopic mucosa is present. Intra-operatively diagnosed Meckel's diverticulum is treated mainly by resection, though the controversies arise for the treatment of co-incidentally found diverticula. We present a case of unusually long Meckel's diverticulum with its tip attached to root of mesentery and causing strangulation of ileal loops underneath it.
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