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Perforated Meckel's diverticulitis complicating active Crohn's ileitis: a case report
Frank Schwenter1, Pascal Gervaz, Philippe de Saussure
1Department of Surgery, University Hospital and Medical School Geneva, 1211 Geneva 14, Switzerland. frank.schwenter@hcuge.ch.
Journal of Medical Case Reports
|January 16, 2009
Summary
Crohn's disease can cause Meckel's diverticulitis. In a unique case, perforated Meckel's diverticulitis in a Crohn's patient allowed for a less invasive surgery, avoiding extensive small bowel resection.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Inflammatory Bowel Disease
Background:
- Crohn's disease (CD) commonly affects the terminal ileum.
- Inflammation extending to a Meckel's diverticulum is possible but rarely influences treatment.
- Concurrent Meckel's diverticulitis and active Crohn's ileitis presents a complex clinical scenario.
Purpose of the Study:
- To describe an original surgical approach for a patient with perforated Meckel's diverticulitis and active Crohn's ileitis.
- To highlight a case where Meckel's diverticulitis facilitated a conservative surgical strategy.
Main Methods:
- Case report of a 22-year-old woman with Crohn's disease.
- Diagnostic imaging (CT scan) revealed ileitis and a suspected perforation.
- Laparoscopic surgery was performed for diagnosis and management.
Main Results:
- Active terminal ileitis and a perforated Meckel's diverticulum with an abscess were identified.
- Meckel's diverticulectomy was performed, avoiding ileocecal resection.
- Pathology confirmed transmural inflammation, granulomas, and perforation in the diverticulum.
Conclusions:
- Crohn's disease can lead to Meckel's diverticulitis and perforation.
- Perforation of Meckel's diverticulum in this context allowed for a less extensive resection.
- This case demonstrates a potential benefit of Meckel's diverticulitis in CD management.
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