1997 Volume 58 Issue 2 Pages 398-401
Meckel's diverticulum is often presented with hemorrhage and acute abdomen including intestinal obstruction, but rarely with some complication due to foreign bodies. We experienced a case of Meckel's diverticulum which was perforated by a fish bone.
A 13-year-old boy was seen at the hospital because of sudden onset of lower abdominal pain. There were tenderness, muscular defense, and peritoneal sign over a wide area of the lower abdomen. White blood cell count was 14, 200/mm3 and CRP was less than 0.3mg/dl. Simple abdominal X-ray examination revealed small intestinal gas in the ileocecal region, and abdominal CT showed an edematous intestine. Emergency operation was carried out with a diagnosis of acute abdomen on the same day. During surgery, a Meckel's diverticulum Y-shaped at the tip was found out in the ileum about 55cm oral side from the ileum end, while the anal side of the diverticulum was perforated by a fish bone. Partial resection of the ileum including the diverticulum was performed. Histologically, abbrration of gastric mucosal tissue was seen, but there were no findings of ulcer formation. It is thought that the peculiar shape of the diverticulum might were have played a role in the perforation.
