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A Meckel's diverticulum presenting as pyogenic liver abscesses

Patrick Field1, Affan Umer1, Mary Ann Mecca-Monahan1

  • 1Saint Francis Hospital and Medical Center, Hartford, Connecticut, USA.

BMJ Case Reports
|August 23, 2015
PubMed

Insights

A Meckel's diverticulum, a common congenital anomaly, rarely causes symptoms. In a rare case, it led to multiple pyogenic liver abscesses, suggesting elective resection for undiagnosed cases.

Area of Science:

  • Gastroenterology
  • Surgical Pathology

Background:

  • Meckel's diverticula are the most common congenital malformation of the small intestine.
  • They are typically asymptomatic, often found incidentally during surgery.
  • Common symptomatic presentations include bleeding in children and obstruction in adults.

Observation:

  • A 50-year-old man presented with multiple pyogenic liver abscesses.
  • Imaging showed a Meckel's diverticulum with a thickened wall but no acute inflammation.
  • Other potential sources for the abscesses were ruled out.

Findings:

  • The Meckel's diverticulum was presumed to be the source of the abscesses.
  • Percutaneous drainage of abscesses and subsequent diverticulum resection were performed.
  • Surgical pathology confirmed acute inflammation and focal abscess within the diverticulum, a rare presentation.

Implications:

  • This case highlights a rare etiology for pyogenic liver abscess.
  • Elective resection of Meckel's diverticulum may be warranted in pyogenic liver abscess cases without other identifiable sources.
  • Consideration of Meckel's diverticulum in the differential diagnosis of pyogenic liver abscess is crucial.

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