Surgical Unit-2, Dow University of Health sciences and Civil Hospital, Karachi, Pakistan.
J Ayub Med Coll Abbottabad. 2020 Oct-Dec;32(4):570-571.
Meckel's diverticulum is the most common congenital anomaly of the GIT with a low incidence of 2% and the complication rate is even lower with perforation being the rarest. We report an intriguing case of a 15-year-old male, who presented with one-week history of high-grade fever and diarrhoea followed by acute onset of abdominal pain in the periumbilical region which became generalized. On physical examination his abdomen was distended with guarding and rigidity. A provisional diagnosis of peritonitis secondary to enteric perforation was made and exploratory laparotomy was done which revealed a perforated Meckel's diverticulum and advanced peritonitis. A diverticulectomy with double barrel ileostomy were performed. No heterotopic tissue in the diverticulum was noted on histopathology, nor any other abnormal tissue identified. The patient made an uneventful recovery postoperatively and ileostomy reconstruction was done two months later. This case report is rare case of Meckel's diverticulum complications and highlights the importance of considering Meckel's diverticulum as a differential diagnosis in every patient presenting with acute abdomen, which can aid toward better management through laparoscopy.
梅克尔憩室是胃肠道最常见的先天性异常，发病率低至 2%，并发症发生率甚至更低，其中穿孔最为罕见。我们报告了一例有趣的病例，一名 15 岁男性，因高热和腹泻病史一周，随后出现脐周急性腹痛，并逐渐扩散至全腹。体格检查发现腹部膨隆，有压痛和肌紧张。初步诊断为肠穿孔继发腹膜炎，并进行了剖腹探查术，发现穿孔的梅克尔憩室和进展性腹膜炎。行憩室切除术和双套管回肠造口术。组织病理学检查未见憩室内异位组织，也未发现其他异常组织。术后患者恢复顺利，两个月后行回肠造口重建。本病例报告为梅克尔憩室并发症的罕见病例，强调了在每个出现急性腹痛的患者中都应考虑梅克尔憩室作为鉴别诊断的重要性，这有助于通过腹腔镜更好地进行管理。
