Case report: preoperatively diagnosed perforated Meckel’s diverticulum containing gastric and pancreatic-type mucosa

Abstract

BackgroundMeckel’s diverticulum is the most common congenital malformation of the gastrointestinal tract, and it represents a persistent remnant of the omphalomesenteric duct. Although it mostly remains silent, its infrequent occurrence is mirrored by the paucity of large series of data on it in the literature. Hemorrhage, obstruction and inflammation are most common complications of Meckel’s diverticulum. Perforation of Meckel’s diverticulum is considered very rare.Case presentationWe present the case of a 17-year -old male, who presented to the emergency department with 1-day history of lower abdominal pain. CT of the abdomen suggested a perforated Meckel’s diverticulum, which was confirmed later at the exploratory laparotomy. Perforation was due to progressive inflammation and presence of gastric and pancreatic tissue found on histopathology.ConclusionPerforation of Meckel’s diverticulum is rarely suspected. Complications of Meckel’s diverticulum can be difficult to diagnose, and early recognition with timely operative intervention must occur in order to provide the best outcome for these patients. This is an interesting and unusual case of Meckel’s diverticulum perforation that highlights the importance of considering Meckel’s diverticulum as a differential diagnosis in every patient presenting with acute abdomen.

Perforated mesenteric Meckel’s diverticulum: Case report

“…Perforation, however, can be life-threatening and the diagnosis can be delayed or missed considering the overlap of clinical symptoms with other causes of acute abdomen, in addition to the often-non-specific findings on imagining. As previously reported, CT scans and ultrasound are not diagnostic as they are unable to differentiate between a diverticulum and a loop of bowel [ 5 ]. Therefore, establishing the correct pre-operative diagnosis can be challenging due to the non-specific symptoms Meckel’s diverticulum can present with.…”

Gastrointestinal sistem kaynaklı konjenital nadir görülen kistik lezyonların histopatolojik değerlendirmesi

“…Hildamus tarafından 1598 yılında tanımlanmıştır. Alman anatomist Johann Friedrich Meckel 1809'da yayınlandığı makalede embriyolojik ve patolojik özelliklerini tarif etmiştir [22]. GIS'in en sık görülen konjenital anomalisidir.…”

“…Literatürde olguların %2'sinde semptom görülmektedir. Tüm yaşam boyu komplikasyon oranı yaklaşık %4'tür [22,23]. En sık rastlanan semptomlar; kanama, takiben bağırsak tıkanıklığı, divertikülit, intussusepsiyon, neoplazi ve perforasyondur [22,24].…”

“…Tüm yaşam boyu komplikasyon oranı yaklaşık %4'tür [22,23]. En sık rastlanan semptomlar; kanama, takiben bağırsak tıkanıklığı, divertikülit, intussusepsiyon, neoplazi ve perforasyondur [22,24]. Olgularımızın 4'ünde (%11) perforasyon, 11'inde (%34) hemoraji ve ülserasyon, 6'sında (%17,6) inflamasyon görüldü.…”

Rare pediatric case of Meckel diverticulum penetration caused by a fish bone

“…reported that there were no cases in which Meckel's diverticulum could be diagnosed preoperatively as a cause of bowel obstruction without a history of laparotomy . Abizeid and Aref, however, reported a case of perforated Meckel's diverticulum preoperatively diagnosed on CT . The preoperative diagnosis rate of Meckel's diverticulum will improve with further advances in imaging modalities.…”