Abdominal Peritonitis Secondary to a Perforated Meckel's Diverticulum: Case Report and Literature Review

Abstract

Meckel's diverticulum is the most common congenital malformation of the gastrointestinal tract. This is a true diverticulum as it contains all the layers of the intestinal wall. It is usually asymptomatic and discovered as an incidental finding during surgery for another cause. In adults, its complication is rare and clinically indistinguishable from an appendiceal condition. It has a risk of complications ranging from 2 to 40%, the most frequent being gastrointestinal bleeding, intestinal obstruction and acute abdomen (diverticulitis or diverticular perforation). We present the clinical case of a 21-year-old male with an initial diagnosis of perforated appendicitis who, upon undergoing exploratory laparoscopy, found diffuse peritonitis secondary to Meckel's diverticulum perforation. This patient underwent laparoscopic surgery for intestinal resection of the segment where the diverticulum was located and an end-to-end enteroanastomosis coupled with an appendectomy, due to presenting intense abdominal pain, cramping/oppressive in the lower hemiabdomen, evidence of peritoneal irritation, alteration of the formula white in laboratory studies and findings suggestive of appendicitis and perforation in the abdominal cavity in imaging studies. Therefore, it is concluded that in cases of acute abdomen, the differential diagnosis of Meckel's diverticulum should be taken into account in those patients who present symptoms related to its complications.