Perforated Meckel’s Diverticulum in an Adult

Abstract

Meckel’s diverticulum is the commonest congenital anomaly of the gastrointestinal tract. Its complications have an extensive variety of clinical and imaging manifestations, extending from benign and indolent findings to acute life-threatening conditions. Complicated Meckel’s diverticulum often constitutes a challenging diagnosis for both the clinician and the radiologist. Therefore, imaging techniques play an important role in this condition in evaluating its complications, determining decision making. We describe a case of a 49-year-old man suffering from right abdominal pain with fever and constipation, during the past 5 days. Laboratory data revealed C-reactive protein of 306 mg/L and leukocytosis. Contrast-enhanced CT features were highly suggestive of perforated Meckel’s diverticulum. The purpose of this article is to emphasize that besides its rarity, Meckel’s diverticulum complications can occur in adult patients.

Perforated Meckel’s Diverticulum with Pancreatic and Gastric Heterotropia and Acute Peritonitis - A Case Report

“…9 Neoplastic causes, like GIST or leiomyoma have been also reported. 10 Perforation due to progressive inflammation of Meckel's Diverticulum or ectopic tissue was reported and was present in our case. Diagnosis of Meckel's Diverticulum is notably difficult, as the symptoms and imaging features are non-specific.…”

Spontaneous Perforation of Meckel’s Diverticulum Presenting as a Rare Cause of Acute Abdomen: A Case Report

“…Nevertheless, based on a study including 202 patients, the incidence of complications decreases with age and the pediatric population is at the higher risk: 4% risk in patients younger than 20, 2% risk in patients younger than 40 and 0% risk in the elderly [7,13,14]. There are four criterias that predicts the complication of an asymptomatic incidental MD, accordingly to a retrospective study: diverticulum longer than 2 cm (17%), male gender (25%), younger than 50 years of age (42%) and presence of ectopic tissue (70%) [4,8]. Those complications include obstruction, inflammation (diverticulitis), bleeding and perforation and, overall, while intestinal hemorrhage and obstruction are most common in pediatric patients, obstruction can be the main complication in adults, with incidence rates varying from 22 to 50% [4].…”

“…Around 60% of DM is composed of heterotopic mucosa, of which over 60% consist of gastric mucosa, and in most cases this heterotopic tissue subsequently causes complications such as inflammation, spontaneous perforation or bleeding [3]. Among the complications, gastrointestinal bleeding and obstruction stand out in pediatric patients while obstruction can be mostly found in adults [2,4]. It is important to highlight that MD inflammation or perforation can mimic acute appendicitis because, although not specific, common symptoms of DM involve vomiting, high fever and abdominal pain [5].…”

Meckel's Diverticulum Enterolith: A Rare Cause of Perforation and Small Bowel Obstruction Presenting as Acute Abdomen

“…Meckel's diverticulum is a rare congenital anomaly. It is a remnant of the incompletely obliterated omphalomesenteric or vitelline duct; it is reported as a true diverticulum because it has the whole layers of the intestinal wall [4]. The vast majority of patients with MD remain clinically asymptomatic [5].…”