Diagnostic difficulties in the treatment of complicated Meckel's diverticulum. Case study

Meckel's diverticulum is a congenital anomaly of the ileum resulting from incomplete involution of the proximal yolk duct (vitelline duct). The prevalence is estimated at 1–3% of the population, with a higher incidence in male patients. Complications occur in 4–16% of cases and may include perforation, hemorrhage, and intestinal obstruction. The nonspecific clinical picture of Meckel's diverticulum complicates diagnosis, as it can mimic various acute surgical abdominal conditions. This article presents a case of patient P., a 32yearold female admitted to the hospital with complaints of pain in the right iliac fossa, nausea, and general fatigue. Initial laboratory and imaging studies did not provide a definitive diagnosis. The diagnosis was established during diagnostic laparoscopy, which revealed perforation of the Meckel's diverticulum with diffuse peritonitis. Surgical treatment included diagnostic laparoscopy, revision and sanitation of the abdominal cavity, laparotomy via VolkovichDyakonov approach, wedge resection of the small intestine, appendectomy, and drainage of the abdominal cavity. Surgical intervention successfully eliminated the pathology. The postoperative period was uneventful. This case highlights the diagnostic challenges of complicated Meckel's diverticulum, its potential to mask as other acute abdominal conditions, and the importance of laparoscopy as both a diagnostic and therapeutic modality. KEYWORDS: Meckel's diverticulum, congenital anomalies, Meckel's diverticulum complications, diagnosis, abdominal surgery. FOR CITATION: Yarovenko G.V., Shestakov E.V., Shulepov P.V., Bezborodov A.I., Andreev I.S., Medvedeva E.S. Diagnostic difficulties in the treatment of complicated Meckel's diverticulum. Case study. Russian Medical Inquiry. 2025;9(9):663–667 (in Russ.). DOI: 10.32364/2587- 6821-2025-9-9-18