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BMJ Case Rep. 2010; 2010: bcr09.2009.2308.
Published online 2010 March 30. doi:  10.1136/bcr.09.2009.2308
PMCID: PMC3029149
Findings that shed new light on the possible pathogenesis of a disease or an adverse effect

Perforation of Meckel’s diverticulum secondary to a large faecolith


A 79-year-old woman presented with a 4 day history of central abdominal pain and vomiting. Clinical examination revealed a distended abdomen with predominantly right sided tenderness. Following an initial period of supportive treatment pending further imaging, evolving abdominal signs became evident. Based on the suspicion of a perforated hollow viscus, an emergency laparotomy was carried out. Operative findings were of a Meckel’s diverticulum with evidence of pressure necrosis and perforation near its apex, which was distended due to a 6 cm faecolith. Resection and primary anastomosis was performed. Despite a lower respiratory tract infection, the patient was deemed clinically stable enough to be discharged on the 24th postoperative day.

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