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

Modi, Sunny; Pillai, Shant Kanapathy; DeClercq, Stefaan

doi:10.1016/j.ijscr.2015.07.029

Cited by 14 publications

(18 citation statements)

References 14 publications

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“…[1,4,5] Lifetime risk of having symptomatic Meckel diverticulum is 4.2%, which decreases with age; with an incidence of perforation being as low as 0.5%. [6,7] Symptomatic Meckel diverticulum presents with vague symptoms and signs that mimic acute appendicitis with abdominal radiographs valuable in showing perforation or obstruction and Computed Tomography (CT) cannot delineate Meckel diverticulum with certainty. [7,8,9] Meckel diverticulum perforation can be made out only during laparotomy, not prior, as it presents with similar features of any other hollow viscous perforation and fish bones account for almost 55% of reported cases and other foreign bodies being needle, nylon bristle of toothbrush, tomato skin, cherrystone with most patients not able to recount any history of such ingestion.…”

Section: Discussionmentioning

confidence: 99%

“…[6,7] Symptomatic Meckel diverticulum presents with vague symptoms and signs that mimic acute appendicitis with abdominal radiographs valuable in showing perforation or obstruction and Computed Tomography (CT) cannot delineate Meckel diverticulum with certainty. [7,8,9] Meckel diverticulum perforation can be made out only during laparotomy, not prior, as it presents with similar features of any other hollow viscous perforation and fish bones account for almost 55% of reported cases and other foreign bodies being needle, nylon bristle of toothbrush, tomato skin, cherrystone with most patients not able to recount any history of such ingestion. [4,8,10] Though, the management of asymptomatic Meckel diverticulum is a much debated topic, it is quite clear that Meckel diverticulum complicated by perforation warrants a segmental resection followed by anastomosis.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Foreign Body-Induced Meckel’s Diverticulum Perforation: An Unheralded Crisis

Prakash¹,

Britto²,

Kashyap³

et al. 2016

jemds

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Foreign Body-Induced Meckel’s Diverticulum Perforation: An Unheralded Crisis

Prakash¹,

Britto²,

Kashyap³

et al. 2016

jemds

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“…A faecolith or enterolith is a rare cause of bowel obstruction, with few case reports in the literature . This is the first reported case of a large bowel faecolith causing a small bowel obstruction by means of an entero‐colic fistula.…”

mentioning

confidence: 93%

Migrating faecolith: an unusual case of small bowel obstruction

Daneel

Kariappa

2018

ANZ Journal of Surgery

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“…Enteroliths within or expelled from a Meckel's diverticulum can be asymptomatic or present with perforation, diverticulitis or bowel obstruction . Small bowel obstruction due to enteroliths forming within a Meckel's diverticulum has been described in approximately 10 published cases .…”

mentioning

confidence: 99%

“…Only a few operative photos, including Figure , of enteroliths arising from a Meckel's diverticulum have been published …”

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confidence: 99%

Meckel's diverticulum enteroliths causing small bowel obstruction

Maurice

Dickfos

Mousa

et al. 2016

ANZ Journal of Surgery

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A 72-year-old man presented to the emergency department with 3 days of vague abdominal discomfort and increasing right-sided abdominal tenderness. He complained of nausea and had opened his bowels earlier that day. His past medical history included a total extraperitoneal bilateral inguinal hernia repair, dyslipidaemia, gastro-oesophageal reflux disease and previous excision of a giant cell tumour from his left radius, which required a bone graft from his right iliac crest.His abdominal X-ray at presentation revealed a circular opacity in the right upper quadrant consistent with a calcified gallstone and two further opacities in the right lower quadrant which had a similar lamellated appearance (Fig. 1).Computed tomography of the abdomen demonstrated a small bowel obstruction with a large lamellated mass within a Meckel's diverticulum and an associated lamellated mass within the small bowel at the neck of the Meckel's diverticulum: the latter mass was the transition point for the small bowel obstruction (Fig. 2). The right upper quadrant mass was confirmed to be a gallstone present within the gallbladder. As there was no evidence of pneumobilia and the liver function tests were normal, it was reasoned that a gallstone ileus was very unlikely.The patient was consented for laparotomy to manage his mechanical small bowel obstruction. Intra-operatively, a large stone was palpable within the Meckel's diverticulum and a further stone was found within the adjoining small bowel, which appeared to cause the small bowel obstruction (Fig. 3). An enterotomy was performed at the tip of the Meckel's diverticulum and both enteroliths were removed. On macroscopic examination, the enteroliths appeared smooth with a fractured edge, suggesting they were likely a single stone that fractured, with one fragment migrating, causing the small bowel obstruction. The Meckel's diverticulum was resected using a stapler.Apart from an ileus, the patient made an unremarkable recovery and was discharged on post-operative day 8.Histology of the specimen demonstrated a Meckel's diverticulum with acute inflammation, focal perforation and submucosal peridiverticular abscess formation. There was no evidence of heterotopic tissue or malignancy.

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

Abstract: HighlightsMeckel’s diverticulum (MD) is a rare condition, present in about 2% of population.MD perforation is a rare phenomena and being caused by faecolith is extremely rare.

Cited by 14 publications

References 14 publications

Foreign Body-Induced Meckel’s Diverticulum Perforation: An Unheralded Crisis

Foreign Body-Induced Meckel’s Diverticulum Perforation: An Unheralded Crisis

Migrating faecolith: an unusual case of small bowel obstruction

Meckel's diverticulum enteroliths causing small bowel obstruction

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