Perforated Meckel’s diverticulitis secondary to a corn kernel obstruction of lumen in an elderly patient

Abstract

Meckel’s diverticulum (MD) is the most common congenital malformation of the gastrointestinal tract. The most frequent complications are bleeding, intestinal obstruction, intussusception and neoplasm. Perforation because of diverticulitis is very rare and usually associated to foreign bodies. We report a case of an elderly man who presented with right iliac fossa pain, raised inflammatory markers and a computer tomography (CT) scan suggestive of Meckel’s diverticulitis. He underwent a laparoscopic converted to open small bowel resection and primary anastomosis for perforated MD, which revealed a corn kernel at its base in the absence of ectopic gastric or pancreatic tissue. Symptomatic and perforated MD secondary to a phytobezoar is extremely rare in elderly patients, hence the importance of clinical suspicion in patients with abdominal pain, independent from their age, to avoid delay in diagnosis, which can lead to increased morbidity and mortality in this demographic.

Fishbone perforating Meckel’s diverticulum: an acute appendicitis mimicker

“…Meckel’s diverticulum is a true diverticulum that arises because of the failure of the obliteration of the vitellointestinal duct, which normally occurs within 9 weeks of gestation [ 1 ]. Less than 10% of Meckel’s diverticulum is diagnosed before surgery, and it is mostly found incidentally during the surgery [ 10 ].…”

“…When perforation occurs, it mainly occurs due to foreign bodies, inflammation, or trauma. There are multiple foreign bodies reported as a cause of perforation of Meckel’s diverticulum, and fish bones are one of the important causes of perforation, accounting for around 55% of the cases [ 1 ].…”

“…Meckel’s diverticulum is a relatively common gastrointestinal abnormality caused by incomplete obliteration of the omphalomesenteric duct, which usually occurs within the first 9 weeks of gestation. It is a true diverticulum, containing all three layers of the bowel wall, and it originates at the antimesenteric border [ 1 ]. Although most patients with Meckel’s diverticulum are asymptomatic throughout their lives, ~4%–6% of the patients develop complications, including gastrointestinal bleeding, intestinal obstruction, intussusception, diverticulitis, enteroliths, perforation, fistula, and tumors [ 2 ].…”

A Case Report on Fish Bone Perforating Meckel’s Diverticulum Mimicking Appendicitis

“…The inability of the omphalomesenteric duct to regress during the first nine weeks post conception leads to a defect of the gastrointestinal tract known as Meckel’s diverticulum (MD) [ 1 ]. It is a type of true diverticulum consisting of all the three layers of the bowel wall and usually arises from the antimesenteric border [ 2 ].…”