CROHN'S DISEASE WITHIN MECKEL'S DIVERTICULUM: CASE REPORT

Dr. Faten Limaiem* and Saadia Bouraoui

ABSTRACT

Meckel's diverticulum has been reported in patients with Crohn's disease with an incidence of 6 to 18.5%. The direct involvement of a Meckel's diverticulum by Crohn's disease is less common and is usually the result of contiguous spread. A 24-year-old male patient with no particular medical history, presented with severe abdominal pain for the past 24 hours. Abdominal examination revealed mild distension with generalized guarding and marked rebound tenderness. Computed tomography scan showed ileal wall thickening with partial obstruction. It also disclosed enlarged mesenteric lymph nodes. The patient underwent ileal resection and mesenteric lymphadenectomy. Grossly, the specimen consisted of a 28-cm segment of thickened ileum with a Meckel's diverticulum measuring 3 cm. Microscopic study revealed typical transmural Crohn's disease involving the ileum as well as Meckel's diverticulum, with narrow ulcerated fissures coated by granulation tissue, fibrin and polymorphonuclear leukocytes. The final pathological diagnosis was Meckel's diverticulum involved by the inflammatory lesions of Crohn's disease. Postoperative course was uneventful.

Keywords: Crohn's disease, Meckel's diverticulum, small intestine, pathology.