A case of perforation of a meckel's diverticulum caused by a fish bone after total gastrectomy

Abstract

In general, Meckel's diverticulum causes no symptoms. However, it can sometimes result in abdominal pain, which can require treatment. We report a case with a perforated Meckel's diverticulum caused by a fish bone. A 67-year-old man had a total gastrectomy 3 years previously. He developed lower abdominal pain. Acute peritonitis of unknown cause was suspected, and a laparotomy was done. It was found that a fish bone, about 4.3 cm long, had perforated the Meckel's diverticulum and then had entered the abdominal cavity. The diverticulum was located in the small intestine about 50 cm proximal from the ileocecal junction. A partial resection of the diverticulum was done.
The present case of Meckel's diverticulum perforated by a fish bone is the seventeenth to have been reported in Japan. None of the previous patients had had a total gastrectomy. Total gastrectomy is a high-risk factor for perforation of the alimentary tract because the absence of gastric acid allows for the easier passage of foreign bodies into the small intestine. Meckel's diverticulum perforation due to a fish bone in a gastrectomized patient is rare.