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. 2017:37:254-256.
doi: 10.1016/j.ijscr.2017.06.053. Epub 2017 Jul 8.

Enterovesical fistula, a rare complication of Meckel's diverticulum: A case report

Bourguiba M A  1 , Gharbi M  2 , Ghalleb M  3 , Ben Taher A  4 , Souai F  5 , Bensafta Y  6 , Sayari S  7 , Ben Moussa M  8
Affiliations

Enterovesical fistula, a rare complication of Meckel's diverticulum: A case report

Bourguiba M A et al. Int J Surg Case Rep. 2017.

Abstract

Introduction: Enterovesical fistulas usually result from diverticulitis, Crohn's disease, or colorectal cancer. A perforated Meckel's diverticulum can exceptionally result in an vesico-diverticulum fistula, as noted in only seven previously reported cases.

Case report: A 35-year old Arabic male, quadriplegic,who presented epigastralgia evolving for a week, associated with abdominal distension and cloudy urine. On examination he was feverish (38.5°C), dehydrated with tenderness in the entire distended abdomen; rectal examination revealed a hypotonic sphincter with no other abnormality. After investigations, acute peritonitis diagnosis was retained. Exploratory laparotomy revealed a vesico-diverticular fistula resulting from a performed Meckel's diverticulum. Diverticulectomy, ileostomy and bladder sutures were performed after peritoneal cleansing. The postoperative course was uneventful. The anatomo-pathological examination confirmed the diagnosis of a perforated Meckel's diverticulum that did not contain ectopic gastric or pancreatic tissue.

Conclusion: Vesico-diverticular fistula resulting from a perforated Meckel's diverticulum is a rare complication. To our knowledge, this is only the fourth reported case which is not associated to inflammatory bowel disease.

Keywords: Meckel’s diverticulum; Surgery; Vesicoentericfistula.

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Figures

Fig. 1
Fig. 1
Per operative view: Meckel’s diverticulum (A) adherent to the bladder dome (B).
Fig. 2
Fig. 2
Per operative view: Meckel’s diverticulitis (A) bladder fistula (B).
See this image and copyright information in PMC

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