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Journal of Medical Case Reports

, 3:12

First Online: 13 January 2009Received: 10 March 2008Accepted: 13 January 2009DOI: 10.1186-1752-1947-3-12

Cite this article as: Schwenter, F., Gervaz, P., de Saussure, P. et al. J Med Case Reports 2009 3: 12. doi:10.1186-1752-1947-3-12


IntroductionIn Crohn-s disease, the extension of active terminal ileitis into a Meckel-s diverticulum is possible, but usually has no impact on clinical decision-making. We describe an original surgical approach in a young woman presenting with a combination of perforated Meckel-s diverticulitis and active Crohn-s ileitis.

Case presentationWe report the case of a 22-year-old woman with Crohn-s disease, who was admitted for abdominal pain, fever and diarrhoea. CT scan demonstrated active inflammation of the terminal ileum, as well as a fluid collection in the right iliac fossa, suggesting intestinal perforation. Laparoscopy was performed and revealed, in addition to extensive ileitis, a 3 × 3 cm abscess in connection with perforated Meckel-s diverticulitis. It was therefore possible to avoid ileocaecal resection by only performing Meckel-s diverticulectomy; pathological examination of the surgical specimen revealed the presence of transmural inflammation with granulomas and perforation of the diverticulum at its extremity.

ConclusionCrohn-s disease of the ileum may be responsible for Meckel-s diverticulitis and cause perforation which, in this case, proved to be a blessing in disguise and spared the patient an extensive small bowel resection.

AbbreviationsBDtwice daily

CTcomputed tomography

ODonce daily

TIDthree times daily

Electronic supplementary materialThe online version of this article doi:10.1186-1752-1947-3-12 contains supplementary material, which is available to authorized users.

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Autor: Frank Schwenter - Pascal Gervaz - Philippe de Saussure - Thomas McKee - Philippe Morel


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