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Case report: preoperatively diagnosed perforated Meckel's diverticulum containing gastric and pancreatic-type mucosa
Georges A Abizeid1, Hager Aref2
1International Medical Center, Jeddah, Saudi Arabia.
Background:
Meckel's diverticulum is the most common congenital malformation of the gastrointestinal tract, and it represents a persistent remnant of the omphalomesenteric duct. Although it mostly remains silent, its infrequent occurrence is mirrored by the paucity of large series of data on it in the literature. Hemorrhage, obstruction and inflammation are most common complications of Meckel's diverticulum. Perforation of Meckel's diverticulum is considered very rare.
Case Presentation:
We present the case of a 17-year -old male, who presented to the emergency department with 1-day history of lower abdominal pain. CT of the abdomen suggested a perforated Meckel's diverticulum, which was confirmed later at the exploratory laparotomy. Perforation was due to progressive inflammation and presence of gastric and pancreatic tissue found on histopathology.
Conclusion:
Perforation of Meckel's diverticulum is rarely suspected. Complications of Meckel's diverticulum can be difficult to diagnose, and early recognition with timely operative intervention must occur in order to provide the best outcome for these patients. This is an interesting and unusual case of Meckel's diverticulum perforation that highlights the importance of considering Meckel's diverticulum as a differential diagnosis in every patient presenting with acute abdomen.
Insights
Perforation of Meckel's diverticulum is a rare complication of this common congenital anomaly. Early diagnosis and surgical intervention are crucial for favorable outcomes in patients with acute abdominal pain.
Area of Science:
- Gastroenterology
- Surgical Pathology
Background:
- Meckel's diverticulum, a remnant of the omphalomesenteric duct, is the most common congenital gastrointestinal malformation.
- While often asymptomatic, complications like hemorrhage, obstruction, and inflammation can occur.
- Perforation of Meckel's diverticulum is an exceptionally rare event.
Observation:
- A 17-year-old male presented with acute lower abdominal pain.
- Abdominal CT suggested a perforated Meckel's diverticulum.
- Exploratory laparotomy confirmed the perforation.
Findings:
- Histopathology revealed gastric and pancreatic tissues within the diverticulum, indicating ectopic tissue as a cause.
- Progressive inflammation led to the perforation.
Implications:
- Perforation of Meckel's diverticulum is infrequently suspected and challenging to diagnose.
- Timely surgical intervention is essential for optimal patient outcomes.
- Meckel's diverticulum should be considered in the differential diagnosis for acute abdomen.