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Traumatic rupture of a Meckel's diverticulum due to blunt abdominal trauma in a soccer game: A case report
W S Tummers1, J R van der Vorst1, D J Swank1
1Department of Surgery, Groene Hart Hospital, Gouda, the Netherlands.
Introduction:
a Meckel's diverticulum is one of the most common congenital anomalies of the digestive tract. The reported lifetime complication rate is 4%, mostly due to hemorrhage, obstruction, perforation or inflammation. A symptomatic Meckel's diverticulum due to rupture after blunt abdominal trauma is very rare. We believe this case report is the first reporting a rupture of a Meckel's diverticulum after a low velocity blunt abdominal trauma and outlining the importance of a thorough and complete examination of the patient after blunt abdominal trauma.
Presentation Of Case:
a 17-year-old male presented with abdominal pain after blunt abdominal trauma during a soccer game. Physical examination showed signs of peritonitis in all quadrants of the abdomen. During admission the patient deteriorated with decreasing blood pressure and raising pulse rate. A CT-scan showed free abdominal fluid. Our patient was scheduled for an emergent laparotomy where a perforated Meckel's diverticulum with fecal spill was found. A segmental ileal resection was performed. Post-operative, patient developed a pneumonia and also intra-abdominal abscesses treated with percutaneous drainage. After an admission period of 17-days the patient was discharged.
Conclusion:
perforation of a Meckel's diverticulum is rarely suspected as a cause of acute deterioration following blunt abdominal trauma. This case shows the importance of awareness of this kind of injury especially in male patients.
Insights
Rupture of Meckel
Area of Science:
- Gastroenterology
- Trauma Surgery
- Pediatric Surgery
Background:
- Meckel's diverticulum is a common congenital anomaly.
- Complications include hemorrhage, obstruction, perforation, and inflammation.
- Rupture after blunt abdominal trauma is exceptionally rare.
Purpose of the Study:
- To report the first case of Meckel's diverticulum rupture after low-velocity blunt abdominal trauma.
- To emphasize thorough examination post-trauma.
Main Methods:
- A 17-year-old male presented with abdominal pain post-blunt trauma.
- Physical exam revealed peritonitis; patient deteriorated with shock.
- CT scan showed free fluid; emergent laparotomy revealed perforated Meckel's diverticulum.
Main Results:
- Emergent laparotomy confirmed a perforated Meckel's diverticulum with fecal spill.
- Segmental ileal resection was performed.
- Post-operative complications included pneumonia and intra-abdominal abscesses, managed with drainage.
Conclusions:
- Perforation of Meckel's diverticulum is an uncommon cause of deterioration after blunt abdominal trauma.
- Highlights the need for clinical awareness, especially in male patients.
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