Versions
- 2021-06-06 (2)
- 2021-02-28 (1)
Keywords
Small bowel obstruction
Pregnancy
How to Cite
Abstract
Meckel’s diverticulitis is an extremely rare cause of acute abdomen during pregnancy. Depending on the clinical presentation it can be managed either by laparoscopy or laparotomy. We report the case of a 29-year-old pregnant female, presenting with abdominal pain and distension in the early second trimester.
The abdominal Ultrasound scan was inconclusive. Magnetic resonance imaging showed small bowel obstruction with a dilated ileal loop. An inflamed Meckel’s diverticulum adherent to the fundus of the gravid uterus was identified during laparotomy. Excision of Meckel’s Diverticulum was carried out with a stapling device.
The diagnosis of Meckel’s diverticulitis can be challenging, especially in pregnancy, and a delay in diagnosis can be detrimental to the mother and foetus. Although laparoscopic management has been reported to be safe in the second trimester, in this case, the abdominal distension would have made access challenging and unsafe, and hence the decision to perform a laparotomy was taken.
References
Barber-Millet S, Lledó JB, Castro PG, Gavara IG, Pla NB, Domínguez RG. Update on the management of non-obstetric acute abdomen in pregnant patients. Cir Esp 2016; 94: 257-65.
Pandeva I, Kumar S, Alvi A, Nosib H. Meckel’s diverticulitis as a cause of an acute abdomen in the second trimester of pregnancy: laparoscopic management. Case Rep Obstet Gynecol 2015;2015:835609.
Sagar J, Kumar V, Shah DK. Meckel's diverticulum: a systematic review. JR Soc Med 2006;99:501–505.
Dumper J, Mackenzie S, Mitchell P, Sutherland F, Quan ML, Mew D. Complications of Meckel's diverticula in adults. Can J Surg 2006;49:353–357.
Huerta S, Barleben A, Peck MA, Gordon IL. Meckel’s diverticulitis: a rare etiology of an acute abdomen during pregnancy. Curr Surg 2006;63:290-3.
Rudloff U, Jobanputra S, Smith-Levitin M, Kessler E. Meckel’s diverticulum complicating pregnancy. Arch Gynecol Obst 2005;271:89–93.
Wong YS, Liu SY, Ng SS, Wong VW, Mak OS, Li JC et al. Giant Meckel's diverticulitis: a rare condition complicating pregnancy. Am J Surg 2010; 200:184-5.
Juhasz-Böss I, Solomayer E, Strik M, Raspé C. Abdominal surgery in pregnancy—an interdisciplinary challenge. Dtsch Arztebl Int 2014; 111:465–72.
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright (c) 2021 Array