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Meckel’s diverticulum perforation: Report of a case and review of the literature

  • Case Report
  • Published:
Hellenic Journal of Surgery

Abstract

Meckel’s diverticulum is the most common congenital anomaly of the small bowel. The majority of patients with this anomaly will remain asymptomatic; however, several complications can occur, including diverticulitis, haemorrhage, obstruction, intussusception, and perforation. A 39-year-old man was admitted to the emergency department after complaining of abdominal pain for the past few days. Upon worsening of his clinical status and after completing the diagnostic workup, he was taken to the operating theatre where he was found to have faecal peritonitis due to perforated Meckel’s diverticulum. Although it might be difficult to diagnose Meckel’s diverticulum pathology preoperatively, it should always be sought and identified during a laparotomy for acute abdomen in order to exclude the increased morbidities resulting from its complications.

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References

  1. Edmonson JM. Johann Friedrich Meckel the younger: Meckel’s diverticulum. Gastrointest Endosc 2001; 54:19A–20A

    Article  CAS  PubMed  Google Scholar 

  2. Haubrich WS. Meckel of Meckel’s diverticulum. Gastroenterology 1998; 114:542

    Article  CAS  PubMed  Google Scholar 

  3. Das PC, Rao PL, Radhakrishna K. Meckel’s diverticulum in children. J Postgrad Med 1992; 38:19–2.

    CAS  PubMed  Google Scholar 

  4. Ajaz A. Malik, Shams-ul-Bari, Khurshid A. Wani, Abdul R. Khaja. Meckel’s diverticulum- Revisited. Saudi J Gastro 2010; 16:3–7

    Article  Google Scholar 

  5. Moore KL. The developing Human, (4th ed.). Philadelphia: WB Saunders 1988; p. 228–3.

    Google Scholar 

  6. Furgeon DK, Barnett JL. Meckel’s diverticulum. Am J Gastroenterol 1990; 85:777–8.

    Google Scholar 

  7. Pinero A, Martinez-Barba E, Canteras M, Rodriguez JM, Castellanos G, Parrilla P. Surgical management and complications of Meckel’s diverticulum in 90 patients. Eur J Surg 2002; 168:8–1.

    Article  CAS  PubMed  Google Scholar 

  8. Gokhan Y, Saddetin C, Turgut T. Surg Today 2004; 34:606–8

    Google Scholar 

  9. DiGiacomo JC, Cottone FJ. Surgical treatment of Meckel’s diverticulum. Sough Med J 1993; 86:671–5

    Article  CAS  Google Scholar 

  10. Mayo CW. Meckel’s diverticulum. Proc Staff Meet Mayo Clin 1933; 8:230

    Google Scholar 

  11. Thurley PD, Halliday KE, Somers JM, Al-Daraji WI, Ilyas M, Broderick NJ. Radiological features of Meckel’s diverticulum and its complications. Clinical Radiolgy 2009; 64:109–1.

    Article  CAS  Google Scholar 

  12. Elsayes KM, Menias CO, Harvin HJ, et al. Imaging manifestations of Meckel’s diverticulum. AJR Am J Roentgenol 2007; 189:81–8

    Article  PubMed  Google Scholar 

  13. Jain TP, Sharma R, Chava SP, et al. Pre-operative diagnosis of Meckel’s iverticulum: report of a case and review of literature. Trop Gastroenterol 2005; 26:99–10.

    PubMed  Google Scholar 

  14. Khan NA, Chandramohan M, McDonald S. Meckel diverticulum. Radiol Pediatr 2008; 110;213–7

    Google Scholar 

  15. Baldisserotto M, Maffazzoni DR, Dora MD. Sonographic findings of Meckel’s diverticulitis in children. AJR Am J Roentgenol 2003;180:425–8

    Article  PubMed  Google Scholar 

  16. Portnoy O, Gayer G, Onaca N, et al. Abdominal computerized tomography in the diagnosis of Meckel’s diverticulitis in adults. Israeli Med Assoc J 2001; 3:982–3

    CAS  Google Scholar 

  17. Mortelé KJ, Govaere F, Pattyn P, et al. Giant Meckel’s diverticulum containing enteroliths: typical CT imaging findings. Eur Radiol 2002; 12:82–4

    Article  PubMed  Google Scholar 

  18. Maglinte DDT, Sandrasegaran K, Lappas JC. CT enteroclysis: techniques and applications. Radiol Clin North Am 2007; 45:289–30.

    Article  PubMed  Google Scholar 

  19. Umschaden HW, Gasser J. MR enteroclysis. Radiol Clin North Am 2003; 41:231–4.

    Article  PubMed  Google Scholar 

  20. Kaltenbach T, Nguyen C, Lau J, et al. Multidetector CT enteroclysis localized a Meckel’s diverticulum in a case of obscure GI bleeding. Gastrointest Endosc 2006; 64:441–2

    Article  PubMed  Google Scholar 

  21. Parrish FJ. Small bowel CT-enteroclysis: technique, pitfalls and pictorial review. Australas Radiol 2006; 50:289–9.

    Article  CAS  PubMed  Google Scholar 

  22. Akman C, Korman U, Ogut G, et al. A combination of small bowel imaging methods: conventional enteroclysis with complementary magnetic resonance enteroclysis. Clin Radiol 2005; 60:778–8.

    Article  CAS  PubMed  Google Scholar 

  23. Eglinton T, Fernando C. Bleeding Meckel’s diverticulum diagnosed with enteroclysis and mesenteric angiography. N Z Med J 2004; 117:U1133

    Google Scholar 

  24. Saremi F, Jadvar H, Siegel ME. Pharmacological interventions in nuclear radiology: indications, imaging protocols and clinical results. Radio Graphics 2002; 22:477–9.

    Google Scholar 

  25. Sfakianakis GN, Conway JJ. Detection of ectopic gastric mucosa in Meckel’s diverticulum and in other aberrations by scintigraphy. 1. Pathophysiology and 10-year clinical experience. J Nucl Med 1981; 22:647–5.

    CAS  PubMed  Google Scholar 

  26. Park JJ, Wolff BG, Tollefson MK, et al. Meckel diverticulum: the Mayo Clinic experience with 1476 patients (1950–2002). Ann Surg 2005; 241:529–3.

    Article  PubMed Central  PubMed  Google Scholar 

  27. Ford PV, Bartold SP, Fink-Bennett DM, et al. Procedure guideline for gastrointestinal bleeding and Meckel’s diverticulum scintigraphy. J Nucl Med 1999; 40:1226–3.

    CAS  PubMed  Google Scholar 

  28. Levy AD, Hobbs CM. From the archives of the AFIP. Meckel diverticulum: radiologic features with pathologic correlation. Radio Graphics 2004; 24:565–8.

    Google Scholar 

  29. Pennazio M, Santucci R, Rondonotti E, et al. Outcome of patients with obscure gastrointestinal bleeding after capsule endoscopy: report of 100 consecutive cases. Gastroenterology 2004; 126:643–5.

    Article  PubMed  Google Scholar 

  30. Sandrasegaran K, Maglinte DDT, Jennings SG, et al. Capsule endoscopy and imaging tests in the elective investigation of small bowel disease. Clin Radiol 2008; 63:712–2.

    Article  CAS  PubMed  Google Scholar 

  31. Mylonaki M, Fritscher-Ravens A, Swain P. Wireless capsule endoscopy: a comparison with push enteroscopy in patients with gastroscopy and colonoscopy negative gastrointestinal bleeding. Gut 2003; 52:1122–6

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  32. Fich A, Talley NJ, Shorter RG, Phillips SF. Does Helicobacter pylori colonize the gastric mucosa of Meckel’s diverticulum? Mayo Clin Proc 1990; 65:187–19.

    Article  CAS  PubMed  Google Scholar 

  33. Fa-Si-Oen RP, Roumen MHR, Croiset van Uchelen AAMF. Complications and Management of Meckel’s Diverticulum-A Review. Eur J Surg 1999; 165:674–8

    Article  CAS  PubMed  Google Scholar 

  34. Ays EK, Ibrahim K, Derya E, Yusuf Ç, Og LU, Mustafa KA, et al. Perforation of Meckel’s Diverticulum by a Button Battery: Report of a Case. Surg Today 2007; 37:1115–6

    Article  Google Scholar 

  35. Willis GA, Ho WC. Perforation of Meckel’s diverticulum by an alkaline hearing aid battery. Can Med Assoc J 1982; 126:497–8

    CAS  PubMed Central  PubMed  Google Scholar 

  36. Umit S, Ozgun G, Julide S. Perforation of Meckel’s diverticulum by a fishbone. Royal Australasian College of Surgeons 2008; 1045–1046.

    Google Scholar 

  37. Yagci G, Çetiner S, Tufan T. Perforation of Meckel’s diverticulum by a chicken bone, a rare complication: report of a case. Surg Today 2004; 34:606–8

    Article  PubMed  Google Scholar 

  38. Nishibe M, Nishibe T, Yamashita T, Kaji M, Fukuhara I, Yasuda K. Perforated leiomyosarcoma of Meckel’s diverticulum: report of a case. Surg Today 2001; 31:163–5

    Article  CAS  PubMed  Google Scholar 

  39. Weinstein EC, Docherty MB, Waugh JM. Neoplasms of Meckel diverticulum. Int Abstracts Surg 1963; 116:103–1.

    Google Scholar 

  40. Soltero MJ, Bill AH. The natural history of Meckel’s diverticulum and its relation to incidental removal. Am J Surg 1976; 132:168–7.

    Article  CAS  PubMed  Google Scholar 

  41. Varcoe RL, Wong YW, Taylor CFM, Newstead CL. Diverticulotomy is inadequate treatment for short Meckel’s diverticulum with heterotopic mucosa. ANZ J Surg 2004; 74:869–7.

    Article  PubMed  Google Scholar 

  42. Fa-Si-Oen RP, Roumen RMH, Croiset van Uchelen FAAM. Complications and management of Meckel’s diverticulum: a review. Eur J Surg 1999; 165:674–8

    Article  CAS  PubMed  Google Scholar 

  43. Heider R, Warshauer DM, Behrns KE. Inverted Meckel’s diverticulum as a source of chronic gastrointestinal blood loss. Surgery 2000; 128:107–8

    Article  CAS  PubMed  Google Scholar 

  44. Patsner B, Chalas E, Orr JW, Mann WJ. Stapler resection of Meckel’s diverticulum during gynecologic surgery. Gynecol Oncol 1990; 38:197–9

    Article  CAS  PubMed  Google Scholar 

  45. Williams RS. Management of Meckel’s diverticulum. Br J Surg 1981; 68:477–8.

    Article  CAS  PubMed  Google Scholar 

  46. Crostwaite GL. Laparoscopy: the ultimate diagnostic tool for a bleeding Meckel’s diverticulum. Aust N Z J Surg 1997; 67:223–4

    Article  Google Scholar 

  47. Sanders LE. Laparoscopic treatment of Meckel’s diverticulum. Surg Endosc 1995; 9:724–7

    Article  CAS  PubMed  Google Scholar 

  48. Sarli L, Costi R. Laparoscopic resection of Meckel’s diverticulum: report of two cases. Surg Today 2001; 31:823–5

    Article  CAS  PubMed  Google Scholar 

  49. Schmid SW, Schafer M, Krahenbuhl L, Buchler MW. The role of laparoscopy in symptomatic Meckel’s diverticulum. Surg Endosc 1999; 13:1047–9

    Article  CAS  PubMed  Google Scholar 

  50. Ruh J, Paul A, Dirsch O, Kaun M, Broelsch CE. Laparoscopic resection of perforated Meckel’s diverticulum in a patient with clinical symptoms of acute appendicitis. Surg Endosc 2002

    Google Scholar 

  51. Leijonmarck CE. Meckel’s Diverticulum in the adult. Br J Surg 1986; 73:146–9

    Article  CAS  PubMed  Google Scholar 

  52. Ludtke FE, Mende V. Incidence and frequency of complications and management of Meckel’s diverticulum. Surg Gynecol Obstet 1989; 169:537–4.

    CAS  PubMed  Google Scholar 

  53. Mackey WC, Dineen P. A 50-year experience with Meckel’s diverticulum. Surg Gynecol Obstet 1983; 156:56–6.

    CAS  PubMed  Google Scholar 

  54. Groebli Y, Bertin D, Morel P. Meckel’s diverticulum in adults: retrospective analysis of 119 cases and historical review. Eur J Surg 2001; 167:518–2.

    Article  CAS  PubMed  Google Scholar 

  55. Soltero MJ, Bill AR. The natural history of Meckel’s diverticulum and its relation to incidental removal. Am J Surg 1976; 132:168–7.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Athanasios Marinis.

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Voultsos, M., Marinis, A., Rizos, S. et al. Meckel’s diverticulum perforation: Report of a case and review of the literature. Hellenic J Surg 86, 229–234 (2014). https://doi.org/10.1007/s13126-014-0136-7

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  • DOI: https://doi.org/10.1007/s13126-014-0136-7

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