Zaib Zainab, Habib Rohan, Afzal Muhammad Waqas, Ali Murad
Department of General Surgery, Ayub Teaching Hospital, Abbottabad,Pakistan.
Department of Orthopedic Surgery, Ayub Teaching Hospital, Abbottabad, Pakistan.
J Pak Med Assoc. 2022 Nov;72(11):2308-2309. doi: 10.47391/JPMA.4202.
Meckel's diverticulum is the most common gastrointestinal tract's congenital abnormality. Spontaneous perforation of Meckel's diverticulum is very rare and can mimic acute appendicitis. Here we report the case of an 11-year-old male patient, who was presented to the Surgical A unit of Ayub Teaching Hospital, Abbottabad on 21st January, 2021 with one-day history of abdominal pain, predominantly in the periumbilical area and right iliac fossa, associated with nausea. On physical examination his abdomen was tense, tender with guarding and generalized rigidity. A provisional diagnosis of perforated appendix or enteric perforation of a hollow viscus was made. The patient had an emergency laparotomy, where a perforated Meckel's diverticulum was discovered. Resection of the portion of gut containing Meckel's diverticulum was done along with primary anastomosis. Heterotopic gastric mucosa of diverticulitis, associated with perforation was confirmed on histopathology. The patient made an uneventful recovery during postoperative period. This case report is an interesting and an unusual case of Meckel's diverticulum complication. It highlights the importance of considering Meckel's diverticulum as a differential diagnosis in every patient presenting with acute abdomen in this age group.
梅克尔憩室是最常见的胃肠道先天性异常。梅克尔憩室自发性穿孔非常罕见,且可类似急性阑尾炎。在此,我们报告一例11岁男性患者的病例,该患者于2021年1月21日因腹痛1天就诊于阿伯塔巴德阿尤布教学医院外科A病房,腹痛主要位于脐周和右下腹,并伴有恶心。体格检查时,他的腹部紧张,有压痛、肌卫和全腹强直。初步诊断为阑尾穿孔或中空脏器肠穿孔。患者接受了急诊剖腹手术,术中发现一个穿孔的梅克尔憩室。切除含有梅克尔憩室的肠段并进行一期吻合。组织病理学证实憩室炎合并穿孔的异位胃黏膜。患者术后恢复顺利。本病例报告是一例有趣且不寻常的梅克尔憩室并发症病例。它强调了在该年龄组每一位出现急腹症的患者中,将梅克尔憩室作为鉴别诊断的重要性。