Perforated Meckel’s Diverticulum with a True Enterolith Treated by Laparoscopic Surgery：A Case Report

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  • 腹腔鏡補助下手術で治療した真性腸石を伴うMeckel憩室穿孔の1例
  • フククウキョウ ホジョ シタテジュツ デ チリョウ シタ シンセイ チョウセキ オ トモナウ Meckel ケイシツセンコウ ノ 1レイ

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Abstract

<p>Perforated Meckel’s diverticulum accompanied by a true enterolith is extremely rare. Few studies have reported its preoperative diagnosis and laparoscopic treatment. Herein, we report the case of a male patient in his 30s who was diagnosed as having a perforated Meckel’s diverticulum, with a brief review of the literature. The patient presented with a history of fever and lower abdominal pain. Seven years prior, he had been examined for gastrointestinal bleeding, but the cause could not be determined. Blood test results indicated increased levels of inflammatory response markers. Abdominal computed tomography revealed ileal edema and a small intestinal blind-ended luminal structure. A highly absorptive area in the lumen that appeared to be an enterolith was also observed. The patient was diagnosed as having perforated Meckel’s diverticulum and underwent laparoscopic-assisted small bowel resection. Intraoperative findings showed the Meckel’s diverticulum, with edematous ileal loops in the pelvis. The diverticulum was perforated, and the enterolith had slipped out; subsequently, extracorporeal resection of the ileum was performed. Histopathological examination revealed ectopic gastric mucosa in the diverticulum, and biochemical analysis of the enterolith revealed a bile acid stone. The patient’s postoperative course was uneventful. This case highlights that surgery should be considered in the presence of an enterolith in a Meckel’s diverticulum, even if the patient is asymptomatic.</p>

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