ILEAL OBSTRUCTION DUE TO A COPROLITE MIGRATED FROM A MECKEL’S DIVERTICULUM

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.