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

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.