Perforated Meckel's diverticulum in an adult: Case report and literature review.

ABSTRACT

INTRODUCTION AND IMPORTANCE Meckel's diverticulum (MD) is an unusual clinical condition that occurs in approximately 2-4 %. The complications are more common in children, with a low prevalence in adults, with the main complication in adults being intestinal obstruction followed by diverticulitis with or without perforation. CASE PRESENTATION We present a 30-year-old female patient with a history of an appendectomy. She attends the emergency room due to a four-day history of pain in the lower abdominal quadrants, tachycardia, and leukocytosis, with an abdominal CT scan identifying an inflammatory process of the ileum, suggesting a Meckel's diverticulum, urachus remnant, or foreign body. The patient was taken to surgery, and inflammatory adhesions, including a perforated Meckel's diverticulum with necrotic signs and purulent production, were evidenced. Intestinal resection and ileal anastomosis were performed with no complications at 90 days. CLINICAL DISCUSSION: Preoperative diagnosis is difficult in cases with associated inflammatory conditions and is generally made incidentally during surgery and less frequently with CT scans. Surgical management for patients with MD is still controversial and depends on many factors, including symptoms, related complications, characteristics of the diverticulum, and the patient's clinical condition. Currently, no standardized surgical technique exists, and cases should be individualized. CONCLUSION: Meckel's diverticulum perforation is a rare complication in the adult population and remains a diagnostic and surgical challenge, and the final decision must be individualized.