[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-441898-105":59,"doc-detail-441898-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","perforated-meckels-diverticulum-a-rare-evolution-from-diverticulitis-to-sepsis","Perforated Meckel’s diverticulum - A rare evolution from diverticulitis to sepsis","","Meckel’s diverticulum (MD) is a common congenital gastrointestinal anomaly and is usually asymptomatic, yet it can progress to diverticulitis, bleeding, obstruction, and rarely perforation. A 58-year-old man presented with right lower quadrant pain, fever, and nausea; ultrasound suggested MD, and contrast-enhanced CT confirmed acute diverticulitis. Conservative improvement was followed by microperforation and rapid clinical sepsis within 48 hours. Serial CT imaging documented progression to free perforation, treated by resection and ileostomy with an uneventful recovery.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/perforated-meckels-diverticulum-a-rare-evolution-from-diverticulitis-to-sepsis/441898/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/perforated-meckels-diverticulum-a-rare-evolution-from-diverticulitis-to-sepsis/441898.png","ImageObject",300,407,{"name":92,"@type":93},"Terk","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why was Meckel’s diverticulum initially challenging to diagnose in this case?","Question",{"text":112,"@type":113},"Perforated MD can mimic acute appendicitis, and the initial presentation with right lower quadrant pain, fever, and guarding raised suspicion for appendicitis.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What did the first CT scan show?",{"text":117,"@type":113},"Contrast-enhanced CT confirmed an inflamed ~3.5-cm MD with mural thickening and surrounding fat stranding, consistent with acute diverticulitis, without extraluminal gas or abscess.",{"name":119,"@type":110,"acceptedAnswer":120},"How did the patient’s condition progress and what confirmed free perforation?",{"text":121,"@type":113},"Five days later CT showed new extraluminal gas consistent with microperforation, and within 48 hours a third CT demonstrated pneumoperitoneum and diffuse free peritoneal fluid, confirming free perforation.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},441898,1791099003,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":24,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},1099525198933,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Radiology Ca s e Reports 21 (2026) 1140 – 1144  \nAvailable online [at](at www.sciencedirect.com)[ www.sciencedirect.com](at www.sciencedirect.com)  \njournal [homepage:](homepage: www.elsevier.com/locate/radcr)[ www.elsevier.com/locate/radcr](homepage: www.elsevier.com/locate/radcr)  \n| Case Report\u003Cbr>Perforated Meckel’s diverticulum: A rare evolution from diverticulitis to sepsis ✩,✩✩\u003Cbr>Manuela Montatore, MDa, Maria Grazia Capasso, MDb, Federica Masino, MDa, Marina Balbino, MDa, Giuseppe Guglielmi, MDa,b,∗\u003Cbr>a Department of Clinical and Experimental Medicine, Foggia University School of Medicine, Foggia, FG 71122, Italy b Radiology Unit,“Dimiccoli” Hospital, Barletta, BT 70051, Italy |  |  |\n| --- | --- | --- |\n| a r t i c l e i n f o |  | a b s t r a c t |\n| Article history:\u003Cbr>Received 26 October 2025 Revised 20 November 2025 Accepted 25 November 2025 |  | Meckel’s diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract and affects ∼2% of the population. Although usually asymptomatic, MD may lead to complications including diverticulitis, bleeding, obstruction, and—rarely—perforation. Because perforated MD often mimics acute appendicitis, diagnosis before surgery is frequently missed. We describe a 58-year-old man who presented with right lower quadrant pain, fever, and nausea. Ultrasound excluded appendicitis and raised suspicion for MD. Contrastenhanced CT confirmed an inflamed 3.5-cm MD with surrounding fat stranding, consistent with acute diverticulitis. The patient initially improved with conservative therapy but returned five days later with worsening pain and fever. A second CT revealed microperforation with peridiverticular extraluminal gas and fluid. Within 48 hours, clinical sepsis developed. A third CT demonstrated frank pneumoperitoneum and diffuse peritoneal free fluid. Exploratory laparotomy confirmed a perforated MD, which was resected, followed by ileostomy. Postoperative recovery was uneventful. Although rare, MD perforation is potentially life-threatening. This case uniquely illustrates the radiologic evolution from diverticulitis to microperforation and ultimately free perforation, documented across three consecutive CT examinations. Awareness of this progression may improve early recognition and timely surgical management of complicated MD.\u003Cbr>© 2025 The Authors. Published by Elsevier Inc. on behalf of University of Washington.\u003Cbr>This is an open access article under the CC BY-NC-ND license\u003Cbr>([http://creativecommons.org/licenses/by-nc-nd/4.0/](http://creativecommons.org/licenses/by-nc-nd/4.0/)) |\n| Keywords:\u003Cbr>Meckel’s diverticulum Perforation Diverticulitis\u003Cbr>CT imaging Gastrointestinal anomaly Sepsis\u003Cbr>Abdominal pain |  |  |\n\n✩ Acknowledgments: This article was not supported by any external sources of funding.  \n✩✩ Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.  \n∗ Corresponding author.  \nE-mail address: [giuseppe.guglielmi@unifg.it](giuseppe.guglielmi@unifg.it) (G. Guglielmi).  \n[https://doi.org/10.1016/j.radcr.2025.11.069](https://doi.org/10.1016/j.radcr.2025.11.069)  \n1930-0433/© 2025 The Authors. Published by Elsevier Inc. on behalf of University of Washington. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/licenses/by-nc-nd/4.0/](http://creativecommons.org/licenses/by-nc-nd/4.0/))  \nFig. 1 – Abdominal ultrasound of the right lower quadrant demonstrating a blind-ending, thick-walled tubular structure with the characteristic \"gut signature,\" consistent with Meckel’s diverticulum. No signs of appendiceal inflammation are observed.  \nCase description  \nA 58-year-old man with no relevant medical history presented with acute right lower quadrant abdominal pain, fever (38.2°C), and nausea. Symptoms had worsened over 24 hours. Physical examination revealed localized guarding, rigidity,","cbCaieEQSqUvoZhB","https://ap.wps.com/l/cbCaieEQSqUvoZhB","pdf",1292331,"English","# Case Report\n## Case description\n## Discussion","[{\"question\":\"Why was Meckel’s diverticulum initially challenging to diagnose in this case?\",\"answer\":\"Perforated MD can mimic acute appendicitis, and the initial presentation with right lower quadrant pain, fever, and guarding raised suspicion for appendicitis.\"},{\"question\":\"What did the first CT scan show?\",\"answer\":\"Contrast-enhanced CT confirmed an inflamed ~3.5-cm MD with mural thickening and surrounding fat stranding, consistent with acute diverticulitis, without extraluminal gas or abscess.\"},{\"question\":\"How did the patient’s condition progress and what confirmed free perforation?\",\"answer\":\"Five days later CT showed new extraluminal gas consistent with microperforation, and within 48 hours a third CT demonstrated pneumoperitoneum and diffuse free peritoneal fluid, confirming free perforation.\"}]","Perforated Meckel’s diverticulum - A rare evolution from diverticulitis to sepsis | PDF",1790698007,13]