Ruptured Meckel diverticulum mimicking mucositis in a patient receiving induction therapy for high-risk acute lymphoblastic leukemia.
A Meckel diverticulum is an embryonic remnant of the vitellointestinal duct. It is present in approximately 2% of the population and is estimated to cause symptoms<5% of the time. It generally results in painless bleeding or abdominal pain. Rarely, it can rupture, resulting in peritonitis and gram-negative sepsis. We present the case of a 17-year-old male who ruptured his Meckel diverticulum 23 days after the beginning of induction chemotherapy for high-risk acute lymphoblastic leukemia. We postulate that gastritis caused by dexamethasone, mucositis caused by doxorubicin, and the unique anatomic nature of a Meckel diverticulum may have contributed to this extremely unlikely and previously unreported event.
Kline
Ronald M
RM
Pediatric Division, Comprehensive Cancer Centers of Nevada, Las Vegas, NV 89109, USA. Ronald.Kline@usoncology.com
D000293:Adolescent; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003937:Diagnosis, Differential; D004238:Diverticulitis / Q000139:chemically induced* / Q000601:surgery; D006801:Humans; D007813:Laparotomy; D008297:Male; D008467:Meckel Diverticulum; D052016:Mucositis / Q000175:diagnosis; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy*; D012074:Remission Induction; D016896:Treatment Outcome
D000970:Antineoplastic Agents