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A rare concurrence of acute appendicitis with Meckel's diverticulitis: a case report
Aashish Bastakoti1, Abhikanta Khatiwada2, Nischal Neupane3
1Department of General Surgery, Tribhuvan University Teaching Hospital, Nepal.
Background:
Meckel's diverticulitis is the inflammation of Meckel's diverticulum (MD), a common congenital structural abnormality of the gastrointestinal tract. The simultaneous occurrence of Meckel's diverticulitis with acute appendicitis is extremely rare.
Case Presentation:
A 17-year-old male presented with acute abdominal pain and vomiting, accompanied by tenderness in the right iliac fossa. Laboratory investigations revealed neutrophilia and an elevated leukocyte count, while ultrasound findings were consistent with acute appendicitis. The patient underwent an emergency open appendectomy, during which an inflamed appendix was removed. Incidentally, an inflamed MD was also discovered and managed conservatively.
Discussion:
Acute appendicitis and Meckel's diverticulitis share overlapping clinical and imaging features, making preoperative diagnosis difficult, thereby making intraoperative evaluation essential. The management of Meckel's diverticulitis varies depending on the patient's condition and clinical judgment.
Conclusion:
Given the difficulty in preoperative diagnosis of Meckel's diverticulitis, surgeons should routinely assess for MD during appendectomies, even when acute appendicitis is confirmed. Failing to identify and manage Meckel's diverticulitis may lead to complications and adversely affect patient outcomes.
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