GI and Oncologic Surgery - Unusal Presentations of Meckel`s Diverticulum

We present a series of 3 cases of Meckel`s Diverticulum within a period of 4 weeks. Each case had a unique presentation.

Case 1: A 26 year old man presented with symptoms and signs suggestive of acute appendicitis. His white cell count was 11,000, but no pyrexia. On examination he was tender in his lower abdomen, maximally in the right iliac fossa. At laparoscopy he had serosanguinous fluid in his pelvis and an inflammed mass within the small intestine. At laparotomy he was found to have an inflammed Meckel`s diverticulum (photos). This was resected with a GIA60.

Case 2: A 52 year old patient presented with an acute abdomen of sudden onset. He had previously been fir and well. He underwent a laparotomy where he has found to have free bilious coloured fluid within the peritoneal cavity. He was found to have a spontaneous perforation of a Meckel`s diverticulum with gastric metaplasia.

Case3: A 59 year old patient presented with acute small intestinal obstruction. He had a past history of a laparotomy following a stab  injury 40 years ago. At laparotomy he ameckel`s diverticulum adherent to the anterior abdominal wall vausing small intestinal volvulus and obstruction( photos). This was resected using GIA 60.

Posted by: Ezzat Tadros, Consultant Surgeon, St Bernard`s Hospital, Gibraltar (10-Jun-2015)