Perforated Meckel's Diverticulum in an Adult that Resembles Acute Appendicitis: A Case Report and Review of Literature

TL;DR

A 34-year-old woman was diagnosed with a rare perforated Meckel's diverticulum that mimicked acute appendicitis, highlighting the importance of accurate diagnosis in similar cases.

Contribution

This case report adds to the limited literature on perforated Meckel's diverticulum in adults and emphasizes diagnostic considerations for radiologists.

Findings

Perforated Meckel's diverticulum can clinically resemble acute appendicitis.

Laparoscopic exploration confirmed the diagnosis of a perforated Meckel's diverticulum with phlegmon formation.

Radiologists should consider complicated Meckel's diverticulum in cases of acute abdominal pain with normal appendix findings.

Abstract

Perforation is one of the rarest effects of Meckel's diverticulum and may clinically resemble acute appendicitis.

A 34-year-old woman with pain in the right iliac fossa, nausea, and vomiting for three days was brought to the emergency department. An abdominal examination indicated rebound tenderness in the area of the right iliac fossa. Abdominal ultrasound showed a heterogeneous lesion in the left iliac fossa measuring 5 cm × 3.5 cm × 4 cm with no internal vascularity. Abdominal Computed Tomography (CT) demonstrated a hypodense lesion located left of the midline of the abdomen, which was inseparable from the small bowel at the antimesenteric border. Laparoscopic exploration was performed, and an intraoperative diagnosis of perforated Meckel’s diverticulum with phlegmon formation was made. The patient had an uneventful recovery.

Radiologists should be aware of the possibility of complicated Merkel's diverticulum when encountering cases of acute abdominal pain. If there is a lower abdominal inflammatory process and a normal appendix is identified, there should be a high degree of suspicion when examining the CT scan.

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