A Case of Laparoscopic Surgery for Perforated Meckel’s Diverticulum

Abstract

An 8-year-old boy with acute abdominal pain since morning was brought to our hospital by ambulance. The pain continued for hours and exacerbated after an enema. The abdominal wall was soft and flat, and there was rebound tenderness in the right lower quadrant. Contrast-enhanced abdominal CT revealed free peritoneal air and an edematous wall of the small intestine, and we diagnosed him as having peritonitis due to a perforated appendix and rectal perforation after the enema as the preoperative diagnosis. An emergency laparoscopy-assisted operation was performed. Muddy ascites and perforated Meckel’s diverticulum were found. The appendix was not inflamed. Resection of Meckel’s diverticulum with peritoneal irrigation and prophylactic appendectomy were performed. Histopathology revealed perforation on the transitions of intestinal mucosa and ectopic gastric mucosa. In the case of peritonitis due to intestinal perforation, laparoscopic surgery is useful for diagnosis and treatment.