A RARE CASE OF ILEUS DUE TO MECKEL'S DIVERTICULUM WITH ACUTE APPENDICITIS

Abstract

Meckel's diverticulum is a congenital anomaly of the small intestine caused by annomalous disapperance of the vitelline duct. We report a case of ileus due to Meckel's diverticulum with acute appendicitis which was difficult to diagnose. A 5-year-old girl was seen at the hospital because of frequent nausea and vomiting followed by lower abdominal pain. She had complained of occasuonal abdominal pain for past one year. A diagnosis of acute appendicitis was made and an emergency operation was performed. Pathological diagnosis was acute catarrhal appendicitis. She vomited many times and felt colic pain on the right side of the umbilical region from the first postoperative day. Intestinography through an ileus tube revealed severe stenosis in the small intestine and the second operation was performed on 16th postoperative day. Meckel's diverticulum was found at approximately 50cm oral-side from the terminal ileum, and there was an adhesion between the tip of Meckel's diverticulum and terminal ileum. The 20cm long ileum was incarcerated into the loop between the tip of Meckel's diverticulum and terminal ileum. We have great difficulty in making diagnosis for Meckel's diverticulum in this case due to concurrent acute appendicitis. It is essential to consider this disease as a probable diagnosis when we treat children with ileus of unknown origin or mild appendicitis.