ABDOMEN AGUDO DE ETIOLOGÍA INUSUAL: DIVERTÍCULO DE MECKEL PERFORADO POR UNA ESPINA DE PESCADO.

Abstract

Meckel's diverticulum is the most common congenital malformation of the digestive tract; It has a prevalence that ranges from 0.3% - 2.9% in the general population according to different publications, its incidence is higher in males with a 1.5-4: 1 ratio. In general, they present an asymptomatic course throughout life, but it is estimated that 4.2% will have some associated complication, and 3% will require hospitalization and surgery. A 37-year-old male patient who presented with nonspecific abdominal pain, the physical examination revealed a painful abdomen in the mesogastrium and right lower quadrant, without signs of peritoneal irritation. Laboratory studies without alterations; as there was no improvement in the abdominal condition, it was complemented with a computed tomographic study, which showed a hyperdense linear image in the distal ileum in relation to a probable foreign body. A surgical resolution was decided using a laparoscopic approach; as laparoscopy equipment was not available, an infraumbilical laparotomy was performed. A foreign body was identified in relation to a fishbone that crosses Meckel's diverticulum at 80 cm from the ileocecal valve. A diverticulectomy with linear stapler was performed without complications, the histopathology reported Meckel's diverticulum without evidence of ectopic tissue, and he was discharged after 48 hours. Conclusions: the presence of a Meckel diverticulum as an etiology of an acute abdomen should be taken into account and be part of the differential diagnosis of pain in the right lower quadrant; foreign body perforation being rare.