A CASE OF PERFORATION OF MECKEL'S DIVERTICULUM BY A FISH BONE

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The majority of Meckel's diverticulum cases are silent on the clinical course. Among complications of Meckel's diverticulum, perforation due to a foreign body is uncommon. We report a case of Meckel's diverticulum perforated by a fish bone. A 68-year-old man admitted for sudden onset of right lower abdominal pain had undergone appendectomy previously. We undertook emergency surgery for suspected peritonitis possibly caused by intestinal perforation. At laparotomy, Meckel's diverticulum with a perforation caused by a fish bone 2.5 cm long was found and the Meckel's diverticulum excised. Retrospectively, we reviewed preoperative CT scans and confirmed a liner calcified foreign body as a fish bone in the small intestine.It is rare that a fish bone perforates Meckel's diverticulum and this has been reported only 11 times in the Japanese literature. Most reported cases involved acute onset peritonitis due even to a fish bone and simulated acute appendicitis. Surgery was usually done based on a preoperative diagnosis of perforated appendicitis. No case radiographically demonstrated a fish bone before surgery.
日本臨床外科学会の論文