Meckel?s diverticulum complicating pregnancy

Abstract

Symptomatic Meckel's diverticulum is a rare entity in pregnancy. The clinical presentation is variable and preoperative diagnosis is hampered by the various anatomical and physiological changes of pregnancy that can obscure serious underlying intra-abdominal pathology. We report a 14-year-old who presented at 32 weeks' gestation with worsening abdominal pain, distension, and leukocytosis. Abdominal computed tomography showed a pelvic fluid collection with extraluminal air suggestive of a perforated viscus and mechanical small bowel obstruction with features of a closed-loop obstruction. Explorative laparotomy revealed a perforated Meckel's diverticulum. Multiple adhesions between the appendix and the perforated diverticulum, and phlegmon sequelae led to the incarceration of an adjacent segment of ileum. Meckel's diverticulum in pregnancy can have serious consequences. There is a high rate of perforation due to delayed diagnosis and surgical intervention. Our report and review of the literature suggest that a high index of clinical suspicion can lead to earlier diagnosis and help to keep maternal and fetal morbidity and mortality to a minimum.