Background: Meckel’s diverticulum is the most common congenital anomaly of the gastrointestinal tract, and is typically asymptomatic. However, it can lead to severe complications such as inflammation, bleeding, obstruction, or perforation. Perforation with abscess formation in adults is rare and often mimics other intra-abdominal conditions, such as appendicitis, which can cause diagnostic delays.
Case presentation: A 74-year-old woman presented with lower right quadrant abdominal pain, fever, and leukocytosis. Contrast-enhanced computed tomography revealed thickening of the eco-ascending region with fat stranding. Diagnostic laparoscopy revealed seropurulent fluid and an inflamed appendix, which were removed. Further exploration revealed a gangrenous mass in the distal ileum, prompting a conversion to open surgery. Segmental small bowel resection with primary enteroenteral anastomosis was performed.
Conclusion: This case highlights the diagnostic challenges of Meckel’s diverticulitis in adults and underscores the importance of thorough intraoperative inspection of the distal ileum when appendicitis is suspected. However, the findings are atypical. Early recognition and surgical management are essential to prevent severe complications.
Meckel’s diverticulum, intestinal perforation, diverticulitis, abscess, case report
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