A Case of Meckel's Diverticulitis Suspected of Penetrating into the Ovary

Abstract

A 55-year-old woman was admitted to our hospital because of a 1-week history of right lower abdominal pain. An abdominal plain CT scan suggested a cystic lesion of approximately 25 mm in diameter in the right pelvic cavity, and we were not able to identify the appendix. An abscess in the abdominal cavity or a gynecologic disease was suspected, and we started medical treatment. On the next day, abdominal pain was aggravated and peritoneal stimulating sign was recognized, so that we performed an emergency exploratory laparoscopic surgery. We recognized purulent ascites to have filled the pelvic cavity and the right paracolic gutter and a Meckel's diverticulum near the terminal ileum. The tip of the Meckel's diverticulum adhered to the ovary and formed an abscess. We diagnosed the case as localized peritonitis caused by Meckel's diverticulitis, and performed removal of the Meckel's diverticulum, lavage, drainage of the abdominal cavity and appendectomy. Histopathology revealed that the full thickness of the Meckel's diverticulum where had adhered to the ovary became necrotic. From the pathological findings, we suspected that penetration of the Meckel's diverticulum might be covered by the ovary. The patient was discharged 8 days after the surgery.