Abstract
A 56-year-old man complaining of right lower abdominal pain with muscular defense presented to our hospital's emergency outpatient department. The lower right abdomen was tender, and there was muscular defense. Multidetector-row computed tomography (MDCT) showed a blind-ending intestine-like structure from the small intestine, increased density of the surrounding fat tissue, and ascites. The patient was diagnosed as having diffuse peritonitis due to a perforated Meckel's diverticulum and underwent emergency surgery. Cloudy ascites had accumulated intraperitoneally, and Meckel's diverticulum, which was enlarged and erythematous, was observed 80 cm proximal to the terminal ileum. A diverticulectomy was performed. The postoperative course was uneventful and the patient was discharged seven days after surgery. Histopathological examination showed a Meckel's diverticulum with ectopic gastric mucosa which had developed an ulcer and perforation at the border with the small intestinal mucosa. In the past, special imaging examinations, such as small-bowel series and technetium scintigraphy, were thought to be necessary for the diagnosis of Meckel’s diverticulum. Since 2007, there have been reports on the diagnosis of Meckel's diverticulum based on MDCT findings of a blind-ending pouch. MDCT is useful in the diagnosis of morphologic abnormalities of the digestive tract, including Meckel's diverticulum.
