Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Perforated Meckel’s diverticulum presenting with combined bowel and urinary obstruction and mimicking Crohn’s disease: a case report. | Wong et al. Journal of Medical Case Reports 2010 4 264 http content 4 1 264 JOURNALOF medical ÌỤr case REPORTS CASE REPORT Open Access Perforated Meckel s diverticulum presenting with combined bowel and urinary obstruction and mimicking Crohn s disease a case report Banny S Wong 1 David W Larson2 Thomas C Smyrk3 Amy S Oxentenko1 Abstract Introduction Meckel s diverticulum is a common congenital anomaly of the gastrointestinal tract but is an uncommon cause of serious complications in adults. Although cases of patients with hemorrhage bowel obstruction or perforation associated with Meckel s diverticulum have been reported there have been no prior reports of patients with combined urinary and bowel obstruction due to abscess formation. Case presentation We describe the case of a 21-year-old man with a history of recurrent papillary thyroid cancer but no prior abdominal surgeries who presented with a one-month history of rectal pain and new-onset obstipation with urinary retention. He reported night sweats and weight loss and had a second-degree relative with known Crohn s disease. A digital rectal examination was notable and revealed marked tenderness with proximal induration. A computed tomography scan of the patient s abdomen revealed a large complex circumferential perirectal abscess compressing the rectal lumen and base of the urinary bladder associated with terminal ileal thickening and an ileocecal fistula. A flexible sigmoidoscopy with an endorectal ultrasound scan displayed a complex abscess with extensive mucosal and surrounding inflammation. An exploratory laparotomy revealed a Meckel s diverticulum with a large perforation at its base positioned near the ileocecal fistula and immediately superior to the perirectal abscess. The section of small bowel containing the Meckel s diverticulum the terminal ileum and the cecum were all resected and the abscess was debrided. Conclusions Pre-operative diagnosis of Meckel s diverticulum .
