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- Title
Presumed appendiceal abscess discovered to be ruptured Meckel diverticulum following percutaneous drainage.
- Authors
Yang, Jeannie C.; Rivard, Douglas C.; Morello, Frank P.; Ostlie, Daniel J.
- Abstract
A Meckel diverticulum is an embryonic remnant of the omphalomesenteric duct that occurs in approximately 2% of the population. Most are asymptomatic; however, they are vulnerable to inflammation with subsequent consequences including diverticulitis and perforation. We report an 11-year-old boy who underwent laparoscopic appendectomy for perforated appendicitis at an outside institution. During his convalescence he underwent percutaneous drainage of a presumed postoperative abscess. A follow-up drain study demonstrated an enteric fistula. The drain was slowly removed from the abdomen over a period of 1 week. Three weeks following drain removal the patient reported recurrent nausea and abdominal pain. A CT scan demonstrated a 3.7-cm rim-enhancing air-fluid level with dependent contrast consistent with persistent enteric fistula and abscess. Exploratory laparoscopy was performed, at which time a Meckel diverticulum was identified and resected. This case highlights the diagnostic challenge and limitations of conventional radiology in complicated Meckel diverticulum.
- Subjects
SMALL intestine diseases; APPENDICITIS; ABSCESSES; JUVENILE diseases; LAPAROSCOPIC surgery; LAPAROSCOPY; APPENDECTOMY; TOMOGRAPHY
- Publication
Pediatric Radiology, 2008, Vol 38, Issue 8, p909
- ISSN
0301-0449
- Publication type
Article
- DOI
10.1007/s00247-008-0874-1