J Korean Assoc Pediatr Surg.  2015 Dec;21(2):38-41. 10.13029/jkaps.2015.21.2.38.

Panperitonitis due to Perforation of Meckel Diverticulum in Infant Period

Affiliations
  • 1Department of Pediatrics, Wonkwang University School of Medicine, Iksan, Korea. yudoc@wonkwang.ac.kr
  • 2Department of General Surgery, Wonkwang University School of Medicine, Iksan, Korea.

Abstract

The perforation and subsequent panperitonitis as one of the complications of a Meckel diverticulum is a rare complication, especially in infants. Complication of Meckel diverticulum, preoperative and operative patient's mean age is about 5 years old. A 13-month-old male infant presented at our emergency room with currant jelly stool of about 24 hours duration. Intussusception or bacterial enteritis was initially suspected. Gastrointestinal ultrasonography showed no evidence of intussusception or appendicitis. On the 3rd hospital day, he suddenly showed high fever and irritability. Abdominal CT suggested intraperitoneal and retroperitoneal abscess with air collection due to possible bowel perforation. The final diagnosis of perforation of Meckel diverticulum was made by laparoscopy and biopsy. We report a very rare case with perforation of Meckel diverticulum in infant period.

Keyword

Meckel diverticulum; Intestinal perforation; Peritonitis; Infant

MeSH Terms

Abscess
Appendicitis
Biopsy
Diagnosis
Emergency Service, Hospital
Enteritis
Fever
Humans
Infant*
Intestinal Perforation
Intussusception
Laparoscopy
Male
Meckel Diverticulum*
Peritonitis
Tomography, X-Ray Computed
Ultrasonography

Figure

  • Fig. 1 Gastrointestinal ultrasonographic images show normal range of appendix intact (diameter 0.5 cm) (A) and intact ileocecal valve (B).

  • Fig. 2 Abdominal CT shows suspicious intraperitoneal and retroperitoneal abscess with air collection due to suspicious bowel perforation (white arrows).

  • Fig. 3 Perforated Meckel diverticulum (arrow).

  • Fig. 4 Exploratory laparotomy removal of about 5 cm sized Meckel diverticulum.

  • Fig. 5 White arrowhead indicates intestinal tissue; Black arrowhead indicates gastric tissue; Black arrow indicates serosa tissue and inflammation (H&E, ×40).


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