Ostalo

Perforation of Meckel.S Diverticulum . Case Report

Darko Košćak
Ali Allouch
Josip Lovrić

Sažetak

Perforated callous ulcer of Meckel.s diverticulum on the base of heterotopic gastric mucosa, in a 20-year-old man is presented as a relatively rare and unusual case interesting for its localization and histopathologic substrate. Preoperative diagnosis of Meckel.s diverticulum is extremely rare, as there is no efficient and reliable diagnostic procedure in spite of the great diagnostic progress in general. In case of clinical suspicion, multiple diagnostic procedures should be performed to increase the likelihood of preoperative diagnosis. Meckel.s diverticulum is usually detected when inflammatory complications mimicking the clinical picture of acute appendicitis have already set in. There are no specific symptoms of the pathologic changes in Meckel.s diverticulum, thus the diagnosis is most frequently reached intraoperatively, as in the case presented. The patient underwent laparotomy for the clinical picture of diffuse peritonitis. During the operative procedure, a gangrenous, inflamed perforated Meckel.s diverticulum was found, at 80-cm distance from ileocecal valve. The diverticulum was of a thumb size, with a perforation orifice at the base, located on the mesenterial aspect of the intestine. Due to its position, the perforation orifice was located in the triangle formed by the base of diverticulum, ileum and respective mesenterium. Such a localization of Meckel.s diverticulum and perforation orifice required resection of the diverticulum, segments of the intestine with mesenterium, and terminoterminal anastomosis. Based on the heterotopic gastric mucosa, the histopathologic finding indicated a callous perforated ulcer of Meckel.s diverticulum. As the Meckel.s diverticulum consisted of all layers of the ileum wall, there was no doubt that it was a true Meckel.s diverticulum. The postoperative course proceeded uneventfully and the patient was discharged from the hospital on postoperative day 14, in good general condition and with normal abdominal finding.

Ključne riječi

Meckel's diverticulum - surgery; Meckel's diverticulum - pathology; Meckel's diverticulum - complications; Laparoscopy

Hrčak ID:

14087

URI

https://hrcak.srce.hr/14087

Datum izdavanja:

1.5.2006.

Podaci na drugim jezicima: hrvatski

Posjeta: 3.177 *