Case 240: Meckel Diverticulitis

History A previously healthy 28-year-old man developed right lower quadrant pain while traveling. The pain progressed over the course of 2-3 days, and his family took him to a local emergency department. He was found to have an elevated white blood cell count of 12.2 × 10⁹/L (reference range, [3.9-10.3] × 10⁹/L), with a predominance of neutrophils. Contrast material-enhanced computed tomography (CT) of the abdomen and pelvis was performed, and findings were abnormal. The patient elected to leave the emergency department without undergoing treatment, and he returned home via airplane. He presented to his primary care physician for further evaluation later that same day. His physician noted a mildly distended abdomen that was diffusely tender on palpation, with rebound tenderness in the right lower quadrant. The patient was admitted to our hospital, and the general surgery department was consulted. The CT images that were obtained at the outside institution were submitted to our radiology department for interpretation.