Perforation of a Meckel’s diverticulum secondary to chronic NSAID use: case report and review of the literature

Authors

  • Francisco Terrazas Espitia Department of Digestive surgery, Hospital Espanol de Mexico
  • David Molina Davila Department of Digestive surgery, Hospital Espanol de Mexico
  • Luis Villalobos Ramirez Department of Radiology, Hospital Espanol de Mexico
  • Bruno Salazar Trujillo Department of Digestive surgery, Hospital Espanol de Mexico
  • Lucio Santos Moyron Department of Digestive surgery, Hospital Espanol de Mexico
  • Ariadna Mondragon Salgado Department of Digestive surgery, Hospital Espanol de Mexico

DOI:

https://doi.org/10.18203/2349-2902.isj20203797

Keywords:

Meckel´s Diverticulum, Laparoscopy, Advanced laparoscopy, Diverticulum, Gastrosurgery, Laparoscopic intestinal resection, Acute abdomen

Abstract

Meckel´s diverticulum is an abnormality in the development of the gastrointestinal system, its origin and clinical significance was first described by Johan Friedrich Meckel in 1809. It is a remnant of the omphalomesenteric duct which is usually observed following the rule of 2’s, located 2 feet proximal to the ileocecal valve, before 2 years of age in approximately 2% of the population, and is twice as common in male population. It is considered a true diverticulum because it presents all the histopathological layers of the bowel; 6% of the cases present with heterotopic tissue, mainly pancreatic, gastric, colonic or jejunal. We present the case of a 37-year-old patient who presented with acute onset epigastric pain which migrated to the right iliac fossa, he had a history of chronic non-steroidal anti-inflammatory drugs (NSAIDs) usage for articular pain. He underwent abdominal contrast tomography (CT) scan with double iodine contrast enhancement, which revealed the presence of a perforated Meckel´s diverticulum in the antimesenteric portion of the terminal ileum. The patient underwent laparoscopic diverticulectomy with no complications and was discharged 72 hours after the procedure. Histopathological confirmation of a perforated meckel’s diverticulum with heterotopic gastric mucosa confirmed the clinical suspicion of perforation secondary to chronic NSAIDs usage.

Author Biographies

Francisco Terrazas Espitia, Department of Digestive surgery, Hospital Espanol de Mexico

Staff Surgeon Digestive Surgery Department

David Molina Davila, Department of Digestive surgery, Hospital Espanol de Mexico

Associate surgeon Digestive surgery department

Luis Villalobos Ramirez, Department of Radiology, Hospital Espanol de Mexico

3rd year Digestive surgery resident

Bruno Salazar Trujillo, Department of Digestive surgery, Hospital Espanol de Mexico

3rd year Digestive surgery resident

Ariadna Mondragon Salgado, Department of Digestive surgery, Hospital Espanol de Mexico

3rd year Digestive surgery resident

References

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Published

2020-08-27

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Section

Case Reports