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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
PubMed
Abstract

Insights

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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