Perforation Of Meckel’s Diverticulum – An Unusual Cause For Acute Abdomen In Pregnancy

Abstract

Symptomatic Meckels diverticulum is an extremely rare entity in pregnancy , and Perforated Meckel’s diverticulum even more. The clinical presentation may be variable as in any case of acute abdomen in pregnancy and the preoperative diagnosis may be hampered by the various anatomical and physiological changes that occur during pregnancy. The treating surgeon should have a high index of suspicion to diagnose such cases , as prompt diagnosis and appropriate treatment is imperative in these cases to prevent high rate of maternal and fetal morbidity. We report one such case of perforation of Meckel’s diverticulum in whom the clinical findings on abdominal examinations did not reveal any signs of peritonitis , the patient underwent spontaneous abortion within a few hours after admission , massive pneumoperitoneum was only diagnosed after a CT scan of abdomen was done . Patient had been treated outside at a local hospital for 3 days conservatively, probably due to normal abdominal findings except for distension . When we did an exploratory laparotomy we found to our surprise a perforated Meckel’s diverticulum with gross fecal contamination , segmental resection and anastomoses was done . The patient was discharged on the 10th post operative day .