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[Subphrenic Meckel's diverticulum as a differential diagnosis to Chilaiditi's syndrome]

Charles Boy Kromann1, Randi Beier Holgersen

  • 1Kirurgisk Afdeling, Helsingør Hospital, 3000 Helsingør, Denmark. charles.kromann@gmail.com

Ugeskrift for Laeger
|December 14, 2011
PubMed

Insights

A rare perforated Meckel's diverticulum (MD) in an elderly woman highlights its potential as a cause of acute abdomen. This case emphasizes MD's importance in differential diagnosis for subphrenic abnormalities.

Area of Science:

  • Gastroenterology
  • Surgical Pathology
  • Diagnostic Imaging

Background:

  • Meckel's diverticulum (MD) is the most common congenital gastrointestinal anomaly, affecting 2-4% of the population.
  • While typically diagnosed in younger individuals, MD can present atypically in older adults.

Observation:

  • A 67-year-old woman presented with acute abdomen and pneumoperitoneum on X-ray.
  • Exploratory laparoscopy revealed a large perforated MD located superior to the right hepatic lobe.
  • Prior CT scans had shown the MD but were misinterpreted.

Findings:

  • The perforated MD was found in an unusual location (over the right hepatic lobe) and in an elderly patient.
  • Misinterpretation of prior imaging highlights diagnostic challenges with atypical MD presentations.

Implications:

  • This case underscores the importance of considering Meckel's diverticulum in the differential diagnosis of acute abdomen, especially with subphrenic abnormalities.
  • Highlights the need for careful review of imaging in elderly patients presenting with non-specific abdominal symptoms.
  • Emphasizes MD as a critical differential diagnosis for subphrenic configurations on CT scans.

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