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Meckel's diverticulum perforation by a fish bone: A case report
André Gonçalves1, Marinho Almeida1, Luís Malheiro1
1Serviço de Cirurgia Geral do Centro Hospitalar de S. Joao, Porto, Portugal.
Introduction:
Meckel's diverticulum is the most common congenital abnormality of the gastrointestinal tract. The perforation of a Meckel's diverticulum by a foreign body is a very rare complication.
Case Presentation:
A 61-year-old male presented to the Emergency Department with complaints with abdominal pain and fever, and abdominal rebound tenderness on physical examination. An intestinal perforation by a foreign body was diagnosed by CT scan. The patient was submitted to a diagnostic laparoscopy and a perforation of a Meckel's diverticulum by a foreign body was identified. The foreign body was removed and a stapled diverticulectomy was performed.
Discussion:
Meckel's diverticulum is asymptomatic in most of the affected individuals, with a 4.2-16.9% probability of symptomatic presentations. The clinical presentation ranges from intestinal obstruction, to bleeding, inflammation and perforation. While children with Meckel's diverticulum present more often with gastrointestinal bleeding, intestinal obstruction is the most common presentation in adults. Foreign body perforation of a Meckel's diverticulum is an extremely rare event. There is general agreement that a symptomatic Meckel's diverticulum should be resected. Laparoscopy is a safe diagnostic and therapeutic tool that can decrease diagnostic time and theoretically avoids the morbidity and mortality of a delayed diagnosis.
Conclusion:
The perforation of a Meckel diverticulum by a foreign body is an extremely rare event and may have a bad prognosis in case of a delayed diagnosis.
Insights
Foreign body perforation of Meckel's diverticulum is rare but serious. Prompt diagnosis and surgical intervention, like laparoscopy, are crucial for favorable outcomes in adults presenting with abdominal pain.
Area of Science:
- Gastroenterology
- Surgical Pathology
- Medical Diagnostics
Background:
- Meckel's diverticulum is the most common congenital gastrointestinal abnormality.
- Perforation by a foreign body is an exceptionally rare complication.
Purpose of the Study:
- To report a rare case of Meckel's diverticulum perforation by a foreign body.
- To highlight the diagnostic and therapeutic role of laparoscopy.
Main Methods:
- A 61-year-old male with abdominal pain and fever underwent CT scan and diagnostic laparoscopy.
- Foreign body removal and stapled diverticulectomy were performed.
Main Results:
- Intestinal perforation by a foreign body within a Meckel's diverticulum was identified.
- Laparoscopy facilitated diagnosis and treatment.
Conclusions:
- Symptomatic Meckel's diverticulum requires resection.
- Laparoscopy offers a safe and effective approach, reducing diagnostic delays.
- Delayed diagnosis of foreign body perforation can lead to poor prognosis.
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