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Published on: October 11, 2018
Perforation of Meckel's diverticulum caused by a chicken bone: a case report
1Department of General Surgery, Royal Blackburn Hospital, Blackburn BB2 3EZ, UK. kim.chan@nhs.net.
Introduction:
Meckel's diverticulum represents a true diverticulum of the ileum containing all three layers of the bowel wall and is found on the wall of the distal ileum, usually about 2 feet from the ileocaecal valve. Although Meckel's diverticulum is a common congenital abnormality of the gastrointestinal tract, it is often difficult to diagnose. Patients with perforation of Meckel's diverticulum may present with right iliac fossa pain, which mimics acute appendicitis.
Case Presentation:
A 17-year-old man presented with a 3-day history of lower abdominal pain. On examination, the patient had tenderness in his right iliac fossa. A provisional diagnosis of acute appendicitis was made. The patient was taken to theatre for laparoscopy with the option of appendicectomy. The appendix was found to be normal. An inflamed and perforated Meckel's diverticulum was found to be the cause of the abdominal pain. Meckel's diverticulectomy was performed. The patient made an uneventful recovery and was discharged with further follow-up in the outpatient clinic.
Conclusion:
Complications of Meckel's diverticulum can be fatal and early recognition leads to appropriate management. This case report highlights the importance of considering Meckel's diverticulum as a differential diagnosis of acute abdomen in a young patient.
Insights
Perforated Meckel
Area of Science:
- Gastroenterology and Surgery
Background:
- Meckel's diverticulum is a common congenital gastrointestinal abnormality.
- It is often challenging to diagnose, despite potential for fatal complications.
- Symptoms like right iliac fossa pain can mimic acute appendicitis.
Purpose of the Study:
- To highlight the importance of considering Meckel's diverticulum in the differential diagnosis of acute abdomen.
- To emphasize the need for early recognition and appropriate management of Meckel's diverticulum complications.
Main Methods:
- A case report of a 17-year-old male presenting with lower abdominal pain.
- Initial diagnosis of acute appendicitis, leading to laparoscopic surgery.
- Identification of a perforated Meckel's diverticulum as the cause of pain.
Main Results:
- Laparoscopic exploration revealed a normal appendix.
- An inflamed and perforated Meckel's diverticulum was identified and surgically treated.
- The patient recovered well and was discharged.
Conclusions:
- Meckel's diverticulum can present with symptoms mimicking appendicitis.
- Prompt diagnosis and surgical intervention are crucial for favorable outcomes.
- Considering Meckel's diverticulum in young patients with acute abdominal pain is vital.
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