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

Abstract

Meckel's diverticulum is the commonest congenital malformation of gastrointestinal tract and represents a persistent remnant of the omphalomesenteric duct. Although it mostly remains silent, it can present as bleeding, perforation, intestinal obstruction, intussusception, and tumours. These complications, especially bleeding, tend to be more common in the paediatric group and intestinal obstruction in adults. Stone formation (lithiasis) in Meckel's diverticulum is rare. We report a case of Meckel's diverticulum lithiasis which presented as an acute abdomen in an otherwise healthy individual. The patient underwent an exploratory laparotomy which revealed a perforated Meckel's diverticulum with lithiasis; a segmental resection with end-to-end anastomosis of small bowel was performed. Patient recovery was delayed due to pneumonia, discharged on day 20 with no further complications at 6 months following surgery.

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

“…Lithiasis of Meckel’s diverticulum which may be faecoliths, bezoars, or gallstones [2] is a rare complication and perforation due to faecolith is even rarer. To our knowledge this would be one of the rare case reports of perforated MD due to a faecolith in an adult patient, encountered with faecolith in situ, with photographic evidence.…”

“…German anatomist Johann Friedrich Meckel first described the embryological and pathological features in 1809 [3] . The incidence of Meckel’s diverticulum (MD) varies between 1 and 2% and carries the lifetime risk of 4–6% to become symptomatic [2] .…”

“…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.…”

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

“…Benign disease includes presence of ectopic gastric mucosa [7], perforation following blunt and penetrating injury abdomen [8], ingestion of foreign body like fish bone or chicken bone [9] and formation of stone in Meckel's diverticulum [10]. Malignant disease includes gastrointestinal stromal tumour [11][12][13], adenocarcinoma of Meckel's diverticulum and Carcinoid tumour.…”

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

“…The incidence of Meckel's diverticula resulting in complications is 4–6% with a more classic presentation in infants under 2 years old 1 2. A much smaller percentage of these complications includes intussusception, where the presentation of per rectal (PR) bleeding is more common within the paediatric age group compared to adults 3.…”