IN A MECKEL’S DIVERTICULUM, PEPTIC PERFORATION - A CLASSIC SNAPSHOT! PERFORACIÓN PÉPTICA EN UN DIVERTICULO DE MECKEL: ¡UNA INSTANTÁNEA TÍPICA!
DOI:
https://doi.org/10.31051/1852.8023.v2.n3.13894Keywords:
divertículo de Meckel, falla multiorgánica, Meckel’s diverticulum, Gastric ectopic rest, Multi Organ Dysfunction SyndromeAbstract
El divertículo de Meckel es un remanente congénito localizado en el ileum distal, el cual resulta de un defecto en el cierre del saco de Yolk. Esta anomalía es comunmente detectada en la poblacion pediátrica antes de los 2 años de edad. Por lo tanto, es una causa extraña de obstrucción intestinal y de mortalidad en adultos. Este es el reporte de un individuo de 26 años con 3 dias de fiebre y seis dias de dolor abdominal y vómito continuo. La laparotomía exploratoria demostró la presencia de una diverticulitis de Merkel y signos de obstrucción intestinal. Se realizó la resección del divertículo y parte del ileum afectado, seguido por anastomosis ileo-ileal. Sin embargo, el curso clinico del paciente se deterioró rápidamente debido al desarrollo de falla renal aguda y multiorgánica. Estas complicaciones llevaron al fallecimiento del paciente en su cuarto dia postoperatorio. En conclusión, la baja frecuencia de esta anomalía en adultos dificulta su diagnostico oportuno, teniendo como consecuencia un aumento en la mortalidad de estos casos clínicos.
Meckel’s diverticulum is a congenital outpouching located in the distal ileum which occurs due to the failure of obliteration of the yolk stalk. The peak age in which this anomaly is mostly found is the paediatric age especially below the age of 2. Hence it is noted as an uncommon cause of intestinal obstruction and fatality in adult life. This is a case report of a 26 year old man with abdominal pain and vomiting for 6 days associated with fever for 3 days. Emergency laparotomy revealed Meckel’s diverticulitis with small bowel obstruction. Meckel’s diverculectomy with ileal resection and ileoileal anastamosis was performed. However, the patient developed renal dysfunction leading to Multiorgan Dysfunction Syndrome and died on the 4th post operative day. This anatomical anomaly is rare in adult patients and is difficult to diagnose early due to its bizarre presentation resulting in high mortality. Hence we find this case of interest.
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