Perforated Meckel's Diverticulum Lithiasis: An Unusual Cause of Peritonitis

Case report: preoperatively diagnosed perforated Meckel's diverticulum containing gastric and pancreatic-type mucosa

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.

Spontaneous Rupture of Adenocarcinoma of Meckel's Diverticulum- A Rare Entity

Meckel's diverticulum is a true diverticulum from remnant of vitelline duct. It is most common congenital anomaly of intestine. It is associated with intestinal atresia and anorectal anomalies. It contains heterotrophic epithelium. Most common heterotrophic mucosa is gastric followed by pancreatic tissue. Adenocarcinoma arising from Meckel's diverticulum is very rare. Spontaneous perforation of adenocarcinoma rarely reported. Most of perforation reported in Meckel's diverticulum diagnosed during intraoperative period. This is a case report of spontaneous rupture of adenocarcinoma of Meckel's diverticulum, which was managed with primary resection and ileostomy.

Perforated Meckel's diverticulum in an adult due to faecolith: A case report and review of literature

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Meckel’s diverticulum (MD) is a rare condition, present in about 2% of population.

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MD perforation is a rare phenomena and being caused by faecolith is extremely rare.

Meckel’s diverticulum (MD) is a persistent remnant of the vitelointestinal duct and is present in 2% of population [1]. It is the most common congenital malformation of the gastrointestinal tract. It can present clinically as haemorrhage, diverticulitis, intussusception, chronic ulceration, intestinal obstruction and perforation. Complicated presentation, especially bleeding, tends to be more common in the paediatric group, whereas intestinal obstruction is more common in adults [2]. Patients with a perforation of Meckel’s diverticulum by an enterolith are rare and may present with right iliac fossa pain, which mimics acute appendicitis.

Perforated Littre's hernia diagnosed on imaging: case report and review of literature

We report the clinical details and imaging findings of a case of perforated Littre's hernia presenting as lower abdominal wall cellulitis in a 50-year-old male. Findings included herniation of an oral contrast opacified blind-ending pouch arising from the anti-mesenteric border of the distal ileum into the right inguinal canal, with extravasation of oral contrast. There were adjacent inflammatory changes with subcutaneous emphysema extending up to the right anterior chest wall. Meckel's diverticulum is rarely diagnosed preoperatively on imaging. We highlight the importance of computed tomography in imaging Meckel's diverticulum.

Meckel's diverticulum with intussusception in a 5-year-old patient with Down's syndrome

Meckel's diverticulum is understood to be the commonest congenital malformation within the gastrointestinal tract with a prevalence of 2%, as found on autopsy studies. Although many cases are asymptomatic, complications can occur including haemorrhage, diverticulitis, chronic ulceration and intestinal obstruction. Intussusception is also a complication, but extremely rare. We present a rare case of Meckel's diverticulum causing intussusception, which was surgically resolved, in a 5-year-old girl. Our aim through this case report is to generate greater awareness of this complication and to provide some potential guidance towards its treatment.