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[Perforated ulcer in Meckel's diverticulum]
Abstract:
Three cases, two women and one man, aged 27, 47 and 79 years with perforated peptic ulcer of Meckel's diverticulum are reported. All patients had diffuse peritonitis. The exact diagnosis of the cause of peritonitis has not been preoperatively established in any of them. In two patients cuneiform excision (diverticulectomy) was performed, and resection and anastomosis of the small intestine in the third. The female patients, aged 79, after an uneventful recovery suddenly died due to an acute heart failure on the eight day after surgery. In other patient suppuration of the wound occurred and convalescence was prolonged. In all cases microscopic examination revealed ectopic gastric mucosa on the top of the diverticulum with peptic ulcer.
Insights
Perforated peptic ulcers in Meckel
Area of Science:
- Gastroenterology
- Surgical Pathology
Background:
- Meckel's diverticulum is a congenital anomaly that can lead to various complications.
- Perforated peptic ulcer within Meckel's diverticulum is a rare but serious presentation.
Observation:
- Reported are three cases (two female, one male) aged 27, 47, and 79 with perforated peptic ulcer of Meckel's diverticulum.
- All patients presented with diffuse peritonitis, with preoperative diagnosis of the cause being challenging.
- Surgical interventions included diverticulectomy in two patients and small intestine resection with anastomosis in one.
Findings:
- Microscopic examination confirmed ectopic gastric mucosa at the diverticulum's apex, causing peptic ulceration.
- Postoperative complications included wound suppuration and prolonged convalescence in one patient.
- One elderly patient experienced sudden death from acute heart failure on postoperative day eight.
Implications:
- This case series highlights the diagnostic difficulty and potential severity of Meckel's diverticulum perforation.
- Prompt surgical intervention is crucial, but complications and mortality remain significant risks.
- Ectopic gastric mucosa is the primary etiology for peptic ulceration in Meckel's diverticula.