Abstract
A Rare Case of Mekel's Diverticulum Perforation by the Gangrenous Appendicitis during Pregnancy
Highlights
When Meckel’s diverticulum is suspected or diagnosed, patients should be surgically treated to prevent any complications to the mother and her fetus
Meckel’s diverticulum is one of the most common congenital malformations of the small intestine affecting 2-4% of the general population and it was first described by Wilhelm Fabricius Hildanus in 1598, but researches regarding the anatomy and the embryology belong to Johann Friedrich Meckel, the Younger in 1809 [1]
Appendicitis is the most common cause of acute abdomen during pregnancy, occurring with a usual frequency of 1 in 5002000 pregnancies, in particular during the second trimester (40% of cases), which amounts to 25% of operative indications for nonobstetric surgery during pregnancy [5]
Summary
Meckel’s diverticulum is one of the most common congenital malformations of the small intestine affecting 2-4% of the general population and it was first described by Wilhelm Fabricius Hildanus in 1598, but researches regarding the anatomy and the embryology belong to Johann Friedrich Meckel, the Younger in 1809 [1] It is a vestigial remnant of the omphalomesenteric duct that normally disappears between 6th and 8th week of pregnancy. The day after blood sample were repeated and PCR was 4.61 mg/dl with WBC 14.400/mL, altered transaminase (AST 96 UI/l and ALT 111 UI/l) and alkaline phosphatase 111 UI/l and another antibiotic was added to the therapy. On day 7 blood sample showed a PCR of 10.12 mg/dl with WBC 7.730/mL and increased transaminase (AST 158 UI/l and ALT 257 UI/l), because of maternal hyperpyrexia (38.6°C), pathological cardiotocography, oligohydramnios and breech presentation, an emergency cesarean section was performed by conventional technique. The histological examination confirmed the gangrenous appendix, the perforated diverticulum and the acute peritonitis
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