Perforation of Meckel’s diverticulum with peritonitis: rare case report and review of literature
Keywords:Meckel’s diverticulum, Perforation, Acute appendicitis
Meckel’s Diverticulum (MD) is the most common congenital anomaly of the small bowel found in 2% of population. The majority of patients with this anomaly will remain asymptomatic; however, several complications can occur, including obstruction, intussusceptions, hemorrhage and diverticulitis. Perforation of Meckel’s diverticulum is rare complication occurring in less than 7% of patients complicated by Meckel’s diverticulum that can often mimic appendicitis. Preoperative diagnosis of perforated Meckel’s diverticulum remains a challenging issue. This case demonstrates that a healthy degree of suspicion for complicated Meckel’s diverticulum should be present when dealing with a questionable diagnosis of appendicitis. We report case of 19 years old boy who presented to emergency department with abdominal pain in right lower quadrant mimicking perforated appendicitis. Exploratory laparotomy disclosed normal appendix and perforation of Meckel’s diverticulum.
Roosswick RP. Perforation of Meckel’s diverticulum by foreign bodies. Postgrad Med J. 1965;7:105-6.
Mortensen NJ, Jones O. The small and large intestines. In: Russell RCG, Williams NS, Bulstrode CJK, eds. Bailey & Love’s Short Practice of Surgery. 24th ed. London, UK: Hodder Arnold; 2004: 1159-1160.
Yahchouchy EK, Marano AF, Etienne JC, Fingerhut AL. Meckel’s diverticulum. J Am Coll Surg. 2001;192:658-62.
Arnold JF, Pellicane JV. Meckel’s diverticulum: a ten-year experience. Am Surg. 1997;63:354-5.
Soltero MJ, Bill AH. The natural history of Meckel’s diverticulum and its relation to incidental removal. Am J Surg. 1976;32:168-73.
Cullen JJ, Kelly KA, Moir CR, Hodge DO, Zinsmeister AR, Melton LJ. Surgical management of Meckel’s diverticulum. An epidemiologic, population-based study. Ann Surg. 1994;220:564-9.
Ludtke FE, Mende V, Kohler H, Lepsien G. Incidence and frequency of complications and management of Meckel’s diverticulum. Surg Gynecol Obstet. 1989;169:537-42.
Evers BM. Small intestine. In: Townsend CM, eds. Sabiston Textbook of Surgery. 17th ed. US: Elsevier; 2004: 1366-1368.
Sharma RK, Jain VK. Emergency surgery for Meckel’s diverticulum. World J Emerg Surg. 2008;3:7-27.
Yamaguchi M, Takeuchi S, Awazu S. Meckel’s diverticulum: investigation of 600 patients in Japanese literature. Am J Surg. 1978;136:247-9.
Toshiki S, Kunihiro H, Yutakata S, Shusaku K. A case of perforation of Meckel’s diverticulum by a fish bone. J Jpn Surg Assoc. 2004;65(9):2405-8.
Kazemia K, Jalaeianc H, Fattahib MR, Hosseinia SV, Shafieea M, Roshana N. Ruptured Meckel’s mesodiverticulum and Meckel’s diverticulum following blunt abdominal trauma. Med Princ Pract. 2008;17:161-3.
Thurley PD, Halliday KE, Somers JM, Al-Daraji WI, Ilyas M, Broderick NJ. Radiological features of Meckel’s diverticulum and its complications. Clin Radiol. 2009;64(2):109-18.
Elsayes KM, Menias CO, Harvin HJ, Francis IR. Imaging manifestations of Meckel’s diverticulum. AJR Am J Roentgenol. 2007;189:81-8.
Ediz A, Salih P, Emre G, Feridun S. Laparoscopy-assisted resection of complicated Meckel’s diverticulum in adults. Surg Laparosc Endosc Percutan Techniq. 2002;12(3):190-4.
Palanivelu C, Rangarajan M, Senthilkumar R, Madankumar MV, Kavalakat AJ. Laparoscopic management of symptomatic Meckel’s diverticula: a simple tangential stapler excision. JSLS. 2008;12(1):66-70.