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Case Reports 2018
Medical Case Reports
ISSN: 2471-8041
Page 43
May 28-29, 2018
London, UK
8
th
Edition of International Conference on
Clinical and Medical Case Reports
M
eckel’s diverticulum (MD) is the most prevalent congenital
anomaly of the alimentary tract. An appendectomy is
one of the most commonly performed abdominal procedures
in pediatric population. Meckel’s diverticulum (MD) can
occasionally be found as an incidental finding at the time of
appendectomy. Although Meckel’s diverticulitis and appendicitis
both are considered as relatively common surgical problems in
pediatric population, complications such as bowel obstruction,
hemorrhage, diverticulitis, perforation, and intussusceptions can
occur but the coexistence of both appendicitis and a perforated
Meckel’s diverticulitis is fairly rare. Here, we present a rare case
with a simultaneous coexistence of appendicitis and a perforated
Meckel’s diverticulum in an 18 months old male child who
presented to the emergency department with a 4 days history
of fresh per rectal bleeding with lethargy and vomiting. His
abdomen had localized tenderness in the periumbilical region. An
abdominal ultrasound revealed minimal free fluid with thickened
bowel loops in right iliac fossa. Enlarged mesenteric nodes were
visualized, appendix was not visible. CT scan of his abdomen
showed a linear elongated structure extending up to midline
measuring 5.3x1.0 cmwith a hypo dense collection of 2.5x1.8 cm
with air lucencies adjacent to it. There was adjacent mesenteric
fat streaking suggesting perforated Meckel’s diverticulitis. An
exploratory laparotomy through a right transverse supraumbilical
incision was performed. Loops of terminal small bowel noticed to
be adherent to the anterior abdominal wall at the site of umbilicus,
on further exploration an enlarged inflamed appendix was found
and a perforated Meckel’s diverticulum was noticed which
was matted with unhealthy and terminal ileal loops. A typical
appendectomy was performed along with resection of unhealthy
small bowel and perforatedMeckel’s diverticulum followed by end
to end anastomosis. The patient had an uneventful recovery and
was discharged on the fifth postoperative day. Histopathology
report confirms the diagnosis. We recommend that searching
for a Meckel’s diverticulum should be done even when an acute
appendicitis has been diagnosed. The reason for this is because
these two conditions may exist simultaneously in small patients.
Biography
Hina Yousuf has completed her fellowship in General Pediatric surgery in
2013. She is currently an assistant professor in a tertiary care setup and
deals with pediatric surgical ailments and covers the on call emergencies on
particular days. Her area of main interest is Pediatric Urology and mainly re-
constructive surgeries related to congenital pathologies. She has a paper on
the institution experience of pediatric laparoscopic surgeries where all kind
of general surgical and urological procedures were dealt laparoscopically
henahyousuf@gmail.comCOexistence of acute appendicitis and perforated Meckel’s
diverticulitis: a rare presentation
Yousuf Hina
and
Sheeraz Syed
Liaquat National Hospital & Medical College, Pakistan
Yousuf Hina et al., Med Case Rep. 2018, Volume 4
DOI:10.21767/2471-8041-C1-002