Dimitriou Ioannis, Evaggelou Neofytos, Tavaki Elefteria, Chatzitheoklytos Eftymios
Department of General Surgery, General Hospital of Thessaloniki, O Agios Dimitrios Kanari 7 Stavroupoli, Thessaloniki PC56430, Greece.
J Med Case Rep. 2013 Oct 2;7:231. doi: 10.1186/1752-1947-7-231.
Meckel's diverticulum is the commonest congenital abnormality of the gastrointestinal tract. Most of them are asymptomatic but can rarely present with forms of complications such as bleeding, obstruction, diverticulitis, intussusception and neoplasm. Patients with a perforation of Meckel's diverticulum by a foreign body are rare and may present with right iliac fossa pain, which mimics acute appendicitis.
A 64-year-old Greek man presented with an eight-hour history of right iliac fossa pain. On examination, our patient had tenderness in his right iliac fossa. A provisional diagnosis of acute appendicitis was made. He was taken to theatre with the option of an appendicectomy. His appendix was found to have an about normal appearance. An inflamed Meckel's diverticulum that had been perforated by a fish bone was found to be the cause of the abdominal pain. A Meckel's diverticulectomy was performed. Our patient made an uneventful recovery and was discharged after two days.
Complications of Meckel's diverticulum can be difficult to diagnose and early recognition and timely operative intervention must occur in order to provide the best outcome for these patients. This is an interesting and unusual case of perforation of Meckel's diverticulum that highlights the importance of considering Meckel's diverticulum as a differential diagnosis in every patient presenting with acute abdomen.
梅克尔憩室是胃肠道最常见的先天性异常。大多数梅克尔憩室无症状，但极少数情况下会出现诸如出血、梗阻、憩室炎、肠套叠和肿瘤等并发症。异物导致梅克尔憩室穿孔的患者罕见，可能表现为右下腹疼痛，类似急性阑尾炎。
一名64岁的希腊男性因右下腹疼痛8小时前来就诊。检查时，患者右下腹有压痛。初步诊断为急性阑尾炎。他被送往手术室准备进行阑尾切除术。术中发现其阑尾外观大致正常。发现一根鱼骨穿破了发炎的梅克尔憩室，这就是腹痛的原因。遂进行了梅克尔憩室切除术。患者术后恢复顺利，两天后出院。
梅克尔憩室的并发症可能难以诊断，必须早期识别并及时进行手术干预，以便为这些患者提供最佳治疗效果。这是一例有趣且不常见的梅克尔憩室穿孔病例，凸显了在每例急性腹痛患者中将梅克尔憩室作为鉴别诊断考虑的重要性。
