Alves José Roberto, Justino Gustavo Busch, Justino Leonardo Busch, Ternes Caique Martins Pereira, Rech João Vítor Ternes, Graffunder Fabrissio Portelinha
Diseases of the Abdominal Wall and Digestive System Research Group of the Federal University of Santa Catarina, Florianópolis, SC, Brazil.
Department of Surgery, Polydoro Ernani de São Thiago University Hospital, Federal University of Santa Catarina, Florianópolis, SC, Brazil.
Bull Emerg Trauma. 2021 Apr;9(2):101-104. doi: 10.30476/BEAT.2021.86253.
Meckel's diverticulum is the most common gastrointestinal congenital defect, which, although asymptomatic in adults, may present symptoms in obstruction, inflammation, bleeding and foreign body perforation. There are only 8 reported cases of Meckel's diverticulum perforation by chicken bone. We report a case of a 24-year-old man presenting a 2-day-history of periumbilical pain that shifted to the right lower quadrant in 24 hours. Clinical and laboratory findings led to an appendicitis diagnosis, followed by laparotomy. Normal appendix was found intraoperatively along with an incidental finding of an inflamed and perforated Meckel's diverticulum by chicken bone. Diverticulectomy and enteroanastomosis were performed and the patient had a successful recovery, being discharged after 5 days. Although rare, its clinical presentation might be similar to acute appendicitis, which restate the importance of collecting a detailed clinical history and examining the small bowel in order to investigate a possible Meckel's diverticulum complication in the differential diagnosis.
梅克尔憩室是最常见的胃肠道先天性缺陷,尽管在成年人中通常无症状,但在发生梗阻、炎症、出血和异物穿孔时可能会出现症状。仅有8例鸡骨导致梅克尔憩室穿孔的报道。我们报告一例24岁男性患者,有2天脐周疼痛病史,24小时内转移至右下腹。临床和实验室检查结果导致诊断为阑尾炎,随后进行了剖腹手术。术中发现阑尾正常,同时意外发现一枚鸡骨导致梅克尔憩室发炎并穿孔。进行了憩室切除术和肠吻合术,患者恢复良好,5天后出院。尽管罕见,但其临床表现可能与急性阑尾炎相似,这再次强调了在鉴别诊断中收集详细临床病史和检查小肠以排查可能的梅克尔憩室并发症的重要性。