A Case of Mesenteric Abscess Formation Due to Penetrated Ileal Diverticulum

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A 61-year-old woman was admitted to our hospital after developing fever and right lower quadrant abdominal pain. Physical examination revealed tenderness in the right quadrant of the abdomen and an elastic-hard, egg-sized tumor in the right lower quadrant of the abdomen. Abdominal computed tomography (CT) revealed severe inflammatory changes and abscess formation in the ileocecal region. Gastrografin-enema showed no tumors or diverticula in the right colon. Laparotomy, however, revealed an intra-mesenteric abscess to which the ileum (60cm distal from the ileocecal valve) was strongly adherent. We performed ileocecal resection and partial resection of the ileum. The resected specimen showed a fistula on the mesenteric side, approximately 2 cm proximal to the ileal end, communicating with an abscess. Pathological examination revealed a mesenteric abscess caused by a penetrated pseudo-diverticulum in the terminal ileum. The patient was discharged on the 17<SUP>th</SUP> postoperative day without complications. We report this unusual case and review the relevant Japanese literature.