Perforated mesenteric Meckel's diverticulum in an adult: a real variant?

Abstract

A Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract. It is a real diverticulum that is usually located on the anti-mesenteric edge in the last meter of the ileum. Its location on the mesenteric edge has been rarely reported. It may lead to several complications including perforation that may be life-threatening for the patient. We report herein a case of perforated mesenteric Meckel's diverticulum in an adult patient. Upon surgical exploration by laparotomy, we found a perforated Meckel's diverticulum located on the mesenteric edge of the ileum 60 cm from the ileocoecal junction and 400 ml of seropurulent peritoneal fluid. The patient underwent a segmental ileal resection and an end-to-end anastomosis. The postoperative outcomes were marked by a persistent peritonitis that required successful revision surgery.

Perforated mesenteric Meckel’s diverticulum: Case report

“…Surgical resection is the treatment of choice for symptomatic Meckel’s diverticulum. Procedures made to achieve treatment most commonly include diverticulectomy, segmental bowel resection and anastomosis and wedge resection [ 6 ]. Moreover, finding of an incidental mesenteric Meckel’s should prompt consideration for resection as its location may erode the mesentery and its vasculature causing devastating consequences.…”

Adult intussusception associated with mesenteric Meckel’s diverticulum and antimesenteric ileal polyp

“…It comprises all five layers of the bowel wall, possesses its own blood supply and is invariably within 100 cm proximal to the ileocaecal valve. While classically located on the antimesenteric border of the ileum, the mesenteric variant was first described by Chaffin et al in 19415 and has since been the subject of several case reports 6–17. Some experts contend that these cases should actually be classified as IDCs.…”

Mesenteric Meckel's diverticulum: an unusual cause of small bowel intussusception

“…On the contrary, five cases have presented as surgical emergencies with features similar to acute appendicitis or an acute abdomen with peritonitis. In these cases, intraoperative findings have commented on an acutely inflamed mesenteric MD with either associated adenopathy, perforation or abscess formation 7 8 10 13 15. Therefore many authors have advocated prophylactic resection of incidental mesenteric MD due to its atypical location and fulminant complications that can ensue if left in-situ 4 7–9…”