Abstract
A 49-year-old man underwent upper gastrointestinal series during a medical checkup in February 2009. Two days later he had abdominal pain with fever, and visited our hospital on the following day. He was found to have diffuse tenderness and muscular guarding upon abdominal physical examination and an elevated inflammatory response in blood tests. Abdominal X-ray and computed tomography showed free air, ascites and outlined collection of barium in the lower abdomen. Emergency operation revealed turbid ascites due to the perforated Meckel’s diverticulum located 55 cm oral from the terminal ileum. The diverticulum formed a cystiform shape in the distal half to the connecting pedicle with constriction on the boundary between them. Diverticulectomy was performed. Pathological examination showed the mural necrosis of the cystiform portion of the diverticulum, with no evidence of ectopic mucosa. The perforation of the diverticulum in our case was thought to be caused by increased internal pressure and chemical stimulation due to the stagnated barium collection in the cystiform portion, due to constriction and stenosis on the boundary between the two portions.
