Preoperative diagnosis of Meckel diverticulitis with and without perforation in adult: Two case reports

Background: Meckel's diverticulum, a congenital anomaly arising from incomplete obliteration of the omphalomesenteric duct, often remains asymptomatic but can lead to complications such as diverticulitis and perforation. These complications pose significant diagnostic challenges, especially in adults, and require prompt surgical intervention to achieve optimal outcomes.

Case reports: We report two cases of complicated Meckel's diverticulum in adult male patients. Case 1 was a 40-year-old presenting with atypical epigastric pain and fever, diagnosed with Meckel's diverticulitis and perforation via abdominal sonography and CT imaging instead of initial appendicitis, confirmed through laparoscopic exploration. Case 2 involved a 42-year-old with right flank pain and diarrhoea initially suspected of gastrointestinal infection. Abdominal sonography and CT led to a diagnosis of Meckel's diverticulitis, which was later confirmed and resolved through promptly laparoscopy.

Discussion: Although Meckel's diverticulum predominantly affects children, these cases highlight its clinical significance in adults. The 'rule of 2s' often guides the diagnosis, yet complications can present variably, necessitating careful assessment in advanced imaging modalities. High-frequency ultrasonography and CT scans are crucial for preoperative diagnosis, guiding timely surgical interventions and improving patient outcomes.

Conclusion: An accurate preoperative diagnosis of Meckel's diverticulum and its single or multiple complications could be accurate preoperative diagnosed by process of high-frequency ultrasound followed by CT Scan. The probability of overlapping complications within Meckel's diverticulum scenario should be considered in differential diagnosis which requires the cautiousness of radiologists to prompt a punctual appropriate treatment.