2013 Volume 33 Issue 5 Pages 883-886
An 18-year-old man was brought to our hospital by ambulance with a 2-day history of persistent fever and abdominal pain. The abdominal wall was rigid and there were strong signs of peritoneal irritation Contrast-enhanced abdominal CT revealed free air and a part for the blind end which continued from small intestine, and we diagnosed peritonitis due to perforation of a Meckel's diverticulum. An emergency laparoscopy-assisted operation was performed. Dirty ascitic fluid and perforation of a Meckel's diverticulum were found, and a wedge resection and peritoneal irrigation were performed. Histopathology revealed perforation of a Meckel's diverticulum near its tip and advanced inflammatory cell infiltration and necrosis. No ectopic tissues were detected. With the recent advances in diagnostic imaging, the preoperative diagnosis rate of Meckel's diverticulum is increasing. In the differential diagnosis of acute abdomen, it is important to carefully evaluate CT images of the abdomen taking into consideration the possibility of Meckel's diverticulum.
