PERFORATION OF MECKEL'S DIVERTICULUM DUE TO A FISH BONE -A CASE REPORT-

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Meckel's diverticulum is silent in the clinical course in most cases, and is often detected incidentally at laparotomy. It sometimes causes some complications which include perforation due to a foreign body in a lowest frequency. This paper reports a rare case of perforation of Meckel's diverticulum due to a fish bone. A 60-year-old man was referred to the hospital with a diagnosis of acute appendicitis from another hospital. With a diagnosis of perforative peritonitis due to acute appendicitis, an emergency operation was conducted. It revealed that a foreign body was stipping a 3×5 cm Meckel's diverticulum at 70 cm oral side from the ileocecal region. We made a diagnosis of perforation of the Meckel's diverticulum due to the foreign body, and performed a resection of the diverticulum. The foreign body was a sharp fish bone, 3.5 cm in length and 1.5 mm in diameter. It was comfirmed as a salmon's bone that was inferred from the menu he ate. Pathological study indicated true diverticulum with infiltration of inflammatory cells extending the full thickness. No aberrant tissue, however, was demonstrated. There have been only ten cases of perforation of Meckel's diverticulum due to a fish bone in the Japanese literature so far. This case is thought very rare.
日本臨床外科学会の論文