Faculty mentor/PI email address
jim010@aol.com
Is your research Teaching and Learning based?
1
Keywords
ileal perforation, bowel perforation, abdominal pain, Crohn’s disease
Date of Presentation
5-6-2026 12:00 AM
Poster Abstract
Meckel’s diverticulum is the most common congenital anomaly of the gastrointestinal tract, but clinically significant disease in adulthood is uncommon and often difficult to diagnose before surgery. In adults, symptomatic Meckel’s most often presents with obstruction, bleeding, or inflammation, and cross-sectional imaging may not clearly distinguish it from other distal ileal processes.
We report the case of a 35-year-old man who presented with several days of fever, abdominal pain, vomiting, and diarrhea. CT imaging suggested a complicated distal ileal diverticular process, most concerning for perforated Meckel’s diverticulum with an adjacent abscess. He underwent emergent small bowel resection and abscess drainage. Pathology, however, did not identify Meckel’s diverticulum and instead showed transmural chronic active inflammation with rare poorly formed granulomas, raising concern for Crohn’s disease. Follow-up imaging showed distal ileal strictures involving the ileocecal valve, further supporting chronic fibrostenosing Crohn’s disease.
This case highlights how distal ileal perforation in adults can closely mimic complicated Meckel’s diverticulum on imaging and how the diagnosis may only become clear after pathology review and long-term follow-up.
Disciplines
Digestive System Diseases | Medicine and Health Sciences
Included in
Case Report: Adult Distal lleal Perforation Mimicking Meckel's Diverticulum
Meckel’s diverticulum is the most common congenital anomaly of the gastrointestinal tract, but clinically significant disease in adulthood is uncommon and often difficult to diagnose before surgery. In adults, symptomatic Meckel’s most often presents with obstruction, bleeding, or inflammation, and cross-sectional imaging may not clearly distinguish it from other distal ileal processes.
We report the case of a 35-year-old man who presented with several days of fever, abdominal pain, vomiting, and diarrhea. CT imaging suggested a complicated distal ileal diverticular process, most concerning for perforated Meckel’s diverticulum with an adjacent abscess. He underwent emergent small bowel resection and abscess drainage. Pathology, however, did not identify Meckel’s diverticulum and instead showed transmural chronic active inflammation with rare poorly formed granulomas, raising concern for Crohn’s disease. Follow-up imaging showed distal ileal strictures involving the ileocecal valve, further supporting chronic fibrostenosing Crohn’s disease.
This case highlights how distal ileal perforation in adults can closely mimic complicated Meckel’s diverticulum on imaging and how the diagnosis may only become clear after pathology review and long-term follow-up.