A Case of Mesenteric Abscess Caused by Penetrated Diverticulum of the Terminal Ileum

Satohiko Yanagisawa, Akihito Ozawa, Hisao Ishibashi and Kenichi Arai*

Department of Surgery, Yodakubo Hospital
*Department of Clinical Pathology, Shinshuu University of Medicine

A 49-year-old man presented at our hospital with right lower quadrant abdominal pain and fever. Because the examination showed tenderness and muscular guarding, we suspected local peritonitis due to acute appendicitis or diverticulitis of the ascending colon. Ultrasonography and computed tomograpy showed severer inflammatory change in the terminal ileum than in the ileocecal region, and local peritonitis caused by perforation of acute appendicitis could not be ruled out. At surgery an inflammatory mass was found in the ileocecal region, and there was slight inflammatory swelling of the appendix. The terminal ileum and cecum containing the inflammatory mass was resected. The mass was disclosed to be mesenteric abscess secondary to perforation of the terminal ileum, 3 cm proximal to the ileocecal valve. The pathological diagnosis was mesenteric abscess caused by a penetrated diverticula of the terminal ileum. Since we have had little experience with diverticulum of the ileum, because of their rarity, we report this case of penetration of an ileal diverticulum.

Key words
ileal diverticulum, penetration, mesenteric abscess

Reprint requests
Satohiko Yanagisawa Department of Surgery, Yodakubo Hospital
2857 Furumachi, Nagatomachi, Chiisagata-gun, Nagano, 386-0602 JAPAN

Accepted
March 24, 2004

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