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. 2012;3(1):25-6.
doi: 10.1016/j.ijscr.2011.10.008. Epub 2011 Oct 25.

Acute appendicitis with unusual dual pathology

Georgina E Riddiough  1 , Imran Bhatti, David A Ratliff
Affiliations

Acute appendicitis with unusual dual pathology

Georgina E Riddiough et al. Int J Surg Case Rep. 2012.

Abstract

Introduction: Meckel's diverticulum is a rare congenital abnormality arising due to the persistence of the vitelline duct in 1-3% of the population. Clinical presentation is varied and includes rectal bleeding, intestinal obstruction, diverticulitis and ulceration; therefore diagnosis can be difficult.

Presentation of case: We report a case of acute appendicitis complicated by persistent post operative small bowel obstruction. Further surgical examination of the bowel revealed an non-inflamed, inverted Meckel's diverticulum causing intussusception.

Discussion: Intestinal obstruction in patients with Meckel's diverticulum may be caused by volvulus, intussusception or incarceration of the diverticulum into a hernia. Obstruction secondary to intussusception is relatively uncommon and frequently leads to a confusing and complicated clinical picture.

Conclusion: Consideration of Meckel's diverticulum although a rare diagnosis is imperative and this case raises the question "should surgeons routinely examine the bowel for Meckel's diverticulum at laparoscopy?"

Keywords: Acute appendicitis; General surgery; Meckel's diverticulum; Paediatric surgery.

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Figures

Fig. 1
Fig. 1
Abdominal ultrasound of the right iliac fossa demonstrating a thick walled tubular structure.
Fig. 2
Fig. 2
Abdominal radiograph 5 days post laparoscopic appendicectomy.
See this image and copyright information in PMC

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