Laparoscopic Operation for the Perforated Duplication of Ileum in Adult

Hirotaka Miyai, Tetsushi Hayakawa, Yasunobu Shimizu, Moritsugu Tanaka, Shinya Tanimura, Minoru Yamamoto, Mamoru Morimoto, Ken Tsuboi, Takafumi Sato and Kenta Saito

Department of Surgery, Kariya Toyota General Hospital

We report a case laparoscopy-assisted surgery for adult duplicated ileal perforation. A 38-year-old man seen in an emergency for sudden abdominal pain onset was found in palpation to have severe abdominal tenderness with rebound tenderness and guarding. Abdominal enhanced computed tomography (CT) showed an inflammatory cystic-like tumor in the left abdomen near the navel and very small amount of free air diagnosed as panperitonitis due to Meckel's diverticulum perforation and requiring urgent laparoscopic surgery that day. Laparoscopy showed a perforated diverticulum with a cystic-like tumor about 80 cm from the ileum toward the mesenteries, necessilating partial ileal resection and appendectomy. The diagnosis was a duplicated ileum with ectopic gastric mucosa inside the cyst-like duplication, but having no pathologically detectable continuity with the intestinal tract. No ectopic gastric mucosa was seen in the consecutive diverticuli but the wall was perforated.

Key words
ileal duplication, intestinal perforation, laparoscopic surgey

Reprint requests
Hirotaka Miyai Department of Surgery, Kariya Toyota General Hospital
5-15 Sumiyoshi-Cho, Kariya, 448-8505 JAPAN

Accepted
July 22, 2009

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