Perforated Meckel’s diverticulum is a rare complication of an already rare disease process, which often mimics a perforated appendix on presentation and diagnosis. The majority of case reports for perforation involve either a foreign body or fecalith. We report the case of a 54-year-old female who initially presented at another institution with signs and symptoms of acute appendicitis and underwent appendectomy with a drain left in place. Subsequently, she underwent exploratory laparotomy at our institution for a perceived stump leak or incidental perforation and was found to have a perforated Meckel’s, with no evidence of foreign body or fecalith. The literature of Meckel’s diverticulum is reviewed, and we discuss the difficulty in diagnosis as well as the quandary of incidental resection.

/pdf/spontaneous-perforation-of-meckel-s-diverticulum-in-an-adult-3x7c3opu8c.pdf

Spontaneous perforation of Meckel’s diverticulum in an adult female with literature review

Meckel's diverticulum (MD) is the most common congenital malformation of the gastrointestinal tract. The most frequent complications are bleeding, intestinal obstruction, intussusception and neoplasm. Perforation because of diverticulitis is very rare and usually associated to foreign bodies. We report a case of an elderly man who presented with right iliac fossa pain, raised inflammatory markers and a computer tomography (CT) scan suggestive of Meckel's diverticulitis. He underwent a laparoscopic converted to open small bowel resection and primary anastomosis for perforated MD, which revealed a corn kernel at its base in the absence of ectopic gastric or pancreatic tissue. Symptomatic and perforated MD secondary to a phytobezoar is extremely rare in elderly patients, hence the importance of clinical suspicion in patients with abdominal pain, independent from their age, to avoid delay in diagnosis, which can lead to increased morbidity and mortality in this demographic.

Perforated Meckel's diverticulitis secondary to a corn kernel obstruction of lumen in an elderly patient.

Meckel’s diverticulum is the most common intestinal congenital defect, its prevalence is 0.2%–4.0% and it occurs more commonly in children younger than 2-year old with intestinal bleeding and abdominal pain. Perforation in the elderly is very rare with no more than 35 articles reported worldwide. Here we report the case of a 62-year-old man who was admitted to hospital with a history of acute abdominal pain with a 20-day onset. The patient was treated with laparotomy and 30 cm ileal resection was performed for an 8×5 cm perforated ileum tumour at 50 from ileocecal valve with a side-to-side mechanical anastomosis for reconstruction. Having morbidity Clavien-Dindo scale I in postsurgical and good outcome in 6-month follow-up. Meckel’s diverticulum is an infrequent pathology in paediatric and even rarer in adult population, however, it is always important to keep in mind how to act when is seen either as a finding or as a complication.

Subacute Meckel's diverticulum perforation.

Introduction: Meckel's diverticulum is the commonest congenital abnormality of the gastrointestinal tract. Haemorrhage, obstruction and inflammation are the three main categories of complications resulting from Meckel's diverticulum. Spontaneously perforation of Meckel's diverticulum is very rare and mimics acute appendicitis. Case: 50yr old male patient presented to the emergency room of our institute with abdominal pain for five days associated with fever with chills and complain of vomiting and anorexia. On the subsequent investigation it was found out to be a gastro-intestinal perforation. We operated the patient under general anaesthesia and intra-operative it was found out to be the Meckel’s diverticular perforation. So, we have done resection of contained part and done ileo-ileal anastomosis. Discussion: Meckel’s diverticulum is the result of dysgenesis of the small bowel as it develops in relation to the embryologic yolk sack and arises from the incomplete obliteration of the vitelline duct between the 5th and 8th weeks of gestation. Perforation is an uncommon complication of MD, and the symptom can mimic other acute abdominal conditions such as acute appendicitis as well as gynaecological and urological condition while in the emergency space. We should take diagnosis under consideration as a differential diagnosis when we encounter patients whose impression was firstly acute appendicitis and treatment should be followed accordingly.

Management of a rare case of spontaneous meckel’s diverticular perforation in an old age patient presented in the emergency room

Meckel's diverticulum is an infrequent malformation (2% of the population) and the most frequent complication is bleeding followed by diverticulitis. This usually occurs with clinical signs and symptoms of acute appendicitis in adults. The diagnosis requires a high index of suspicion and is based on complementary tests in most cases (mainly CT).

/pdf/meckel-s-diverticulitis-a-laparoscopic-approach-2yog4ovt8u.pdf

Meckel's diverticulitis: a laparoscopic approach

Perforated Giant Meckel Diverticulitis in an elderly patient: Case report and review of the literature.

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Perforated Giant Meckel Diverticulitis in an elderly patient: Case report and review of the literature.