Rupture of Meckel’s diverticulum after a blunt abdominal trauma: a case report
DOI:
https://doi.org/10.3823/1645Keywords:
Meckel's diverticulum, abdominal trauma, laparotomyAbstract
Background: Meckel’s diverticulum is relatively rare in the general population. Generally, symptoms are extremely varied and prior diagnosis is difficult because of the abnormality being an occasional finding in laparotomies. This report describes the unusual possibility of diverticulum rupture, even after low-impact abdominal trauma. The case is unusual because of the low frequency of small bowel injury in abdominal contusions, except in trauma with high kinetic energy, such as high-speed car crashes, and the unexpected finding of a ruptured diverticulum. Usually, the lesions occur at relatively fixed structures, specifically in the angle of Treitz or ileocecal region, after undergoing stretching.Case presentation: A 32-year-old male patient presented at another service after incurring a trauma in a car crash about 5 hours earlier. He complained of abdominal pain of moderate intensity and intense thirst. Bruises were found on the mesogastric region. Ultrasonography and computed tomography suggested the presence of a small amount of free fluid in the cavity and pneumoperitoneum. Emergency exploratory laparotomy was performed because of the blood and faecal content in the peritoneal cavity. A single lesion, the contusion in Meckel’s diverticulum, was observed. Excision of the segment was performed with thorough washing of the cavity. Conclusion: Patients with Meckel’s diverticulum may be more susceptible to hollow viscus rupture and can be a finding in exploratory laparotomy.
References
- Malik AA, Wani KA, Khaja AR: Meckel’s diverticulum revisited. Saudi J Gastroenterol 2010, 16:3-7.
- Zani A, Eaton S, Rees CM, Pierro A: Incidentally detected Meckel diverticulum: to resect or not to resect? Annals of Surgery:
; 247 (2): 276-81
- Nicholas JM, Rix EP, Easley KA, Feliciano DV, Cava RA, Ingram WV, Parry NG, Rozycki GS, Jeffrey D, Tremblay LN. Changing Patterns in the Management of Penetrating Abdominal Trauma: The More Things Change, the More They Stay the Same. Journal of Trauma-Injury Infection & Critical Care: 2003; 55(6):1095-110
- Germanos S, Gourgiotis S, Villias C, Bertucci M, Dimopoulos N, Salemis N: Damage control surgery in the abdomen: an approach for the management of severe injured patients. Int J Surg 2008, 6:246-252.
- Rotondo MF, Zonies DH: The damage control sequence and underlying logic. Surg Clin North Am 1997, 77:761-777.
- Committee on Trauma: Advanced Trauma Life Support Student Course Manual. Chicago: American College of Surgeons; 2004.
- Varcoe RL, Wong SW, Taylor CF, Newstead GL: Diverticulectomy is inadequate treatment for short Meckel’s diverticulum with heterotopic mucosa. ANZ J Surg 2004, 74:869-872.
- Motta DC, Scarpelini S: Lesões traumáticas de vÃsceras ocas. Medicina (Ribeirão Preto) 2007, 40(4):531-537, out./dez.
– Leite S, Gomes AT, Sousa H: Visceral Injury in abdominal trauma: a retrospective study. Acta Med Port 2013, 26(6):725-730.
- Faria RG, Almeida AB, Moreira H, Barbosa E, Correia-da-Silva P, Costa-Maia J: Prognostic factors for traumatic bowel injuries: killing time. World J Surg 2012, 36:807-812.
- Fleming S, Bird R, Ratnasingham K, Sarker S, Walsh M, Patel B: Accuracy of FAST scan in blunt abdominal trauma in a major London trauma centre. Int J Surg 2012, 10:470-474.
- Brooks A, Simpson J: Blunt and penetrating abdominal trauma. Abdominal Surg 2009, 27:6.
- Leite S, Gomes AT, Sousa H. Visceral Injury in Abdominal Trauma: A Retrospective Study. Acta Med Port 2013 ;26(6):725-30
- McStay C, Ringwelski A, Levy P, Legome E: Hollow viscus injury. J Emerg Med 2009, 37:293-299.
- Tan K, Liu JZ, Go T, Vijayan A, Chiu M. Computed tomography has an important role in hollow viscus and mesenteric injuries after blunt abdominal trauma. Injury 2010, 41:475-478.
- Campillo-Soto A, Soria-Aledo V, Renedo-Villarroya A, Millán MJ, Flores-Pastor B, Girela-Baena E, De Andrés-GarcÃa B, Carrillo-Alcaraz A, MartÃn-Lorenzo JG, Aguayo-Albasini JL. Utilidad de la tomografÃa computari-zada para el diagnóstico de lesiones intestinales y mesentéricas en el trauma abdominal cerrado. Cir Esp 2009, 85:341-347.
- Moore EE, Cogbill TH, Malangoni MA, Jurkovich GJ, Champion HR, Gennarelli TA, McAninch JW, Pachter HL, Shackford SR, Trafton PG: Organ injury scaling II. Pancreas, duodenum, small bowel, colon and rectum. J Trauma 1990, 30(11):1427-29.
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