Meckel's diverticulum perforation by a fish bone mimicking acute appendicitis: A case report and review of the literature

鱼刺刺穿梅克尔憩室,临床表现酷似急性阑尾炎:病例报告及文献综述

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Abstract

INTRODUCTION: Meckel's diverticulum (MD) is the most common congenital abnormality of the gastrointestinal tract and is usually asymptomatic. The perforation of a MD by a foreign body is a very rare complication. CASE PRESENTATION: We report a 53 years old male who presented with intermittent right lower abdominal pain and tenderness in the right iliac fossa on physical examination. With a provisional diagnosis of acute appendicitis, the patient was subjected to open appendectomy. Intraoperatively perforation of MD by an intact fish bone was identified and wedge resection performed. DISCUSSION: Meckel's diverticulum is asymptomatic in most of the individuals with symptoms occurring in only 4-16 %. The clinical presentation ranges from intestinal obstruction, to bleeding, inflammation and perforation. Perforation of a MD due to a foreign body is extremely rare event and most cases are diagnosed during the operation. The treatment of symptomatic MD is surgical resection. CONCLUSION: Perforation of MD should be kept in mind as a differential diagnosis in the evaluation and management of abdominal pain.

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