Occlusione ileale da enterolita migrato da diverticolo di Meckel
F. Tosato 1, F. Corsini 1, S. Marano 1, S. Palermo 1, A. Piraino 1, L. Carnevale 1, F. Scocchera 1, L. Vasapollo 1, A. Paolini 1
Affiliation
Article Info
1 Divisione di IV Semeiotica Chirurgica, Università di Roma “La Sapienza”
Abstract
The authors present a case report of an intestinal obstruction due to a relatively big coprolite migrated from a large Meckel’s diverticulum to the distal Ileum. The patients aparently healthy and a vegetarian, complained on admission of the absence of emission of faeces and gas since four days before with noticeable abdominal distension. In the physical examination he presented intestinal meteorism, a hard abdomen, painful on deep palpation in the median quadrantes, especially in the epigastric and mesogastric ones. The abdominal X-RAY in the standing position confirms :an occlusive state with numerous liquid levels in the Ileum. Because of a worsening of the sintomatology and the apperance of generalized comprimission, two days later an exploratory laparatomy was performed. The intervention showed the presence of a Meckel’s diverticulum with aproximately 10cm in lenght, wiyh an ample neck, the distal Ileum for opponmately 15 cm in dilation returned rapidly to a normal calibre, after a pastous endoluminal formation borned in the Meckel’s diverticulum (Meckel resection presented actually a large niche at the fundus level with a eroded wall) and migrated in the distal Ileum where it could cause the obstruction. In the present case it is probably useful to perform a preoperative CT scan in order to get a precise etiology and perform an ascending Colonscopy, so avoiding a surgical procedure. According to the authores a CT scan is indicated in all cases of intestinal occlusion of unknown case, in order to have a more precise definition of the physiopatology of the occlusion.
Keywords
- Meckel’s diverticulum
- coprolite
