title: Perforated Meckel's diverticulitis complicating active Crohn's ileitis: a case report.
abstract: BACKGROUND
  In Crohn's disease, the extension of active terminal ileitis into a Meckel's diverticulum is possible, but usually has no impact on clinical decision-making. We describe an original surgical approach in a young woman presenting with a combination of perforated Meckel's diverticulitis and active Crohn's ileitis.
  
  
  METHODS
  We report the case of a 22-year-old woman with Crohn's disease, who was admitted for abdominal pain, fever and diarrhoea. CT scan demonstrated active inflammation of the terminal ileum, as well as a fluid collection in the right iliac fossa, suggesting intestinal perforation. Laparoscopy was performed and revealed, in addition to extensive ileitis, a 3 x 3 cm abscess in connection with perforated Meckel's diverticulitis. It was therefore possible to avoid ileocaecal resection by only performing Meckel's diverticulectomy; pathological examination of the surgical specimen revealed the presence of transmural inflammation with granulomas and perforation of the diverticulum at its extremity.
  
  
  CONCLUSIONS
  Crohn's disease of the ileum may be responsible for Meckel's diverticulitis and cause perforation which, in this case, proved to be a blessing in disguise and spared the patient an extensive small bowel resection.
authors.affiliation: Department of Surgery, University Hospital and Medical School Geneva, 1211 Geneva 14, Switzerland. frank.schwenter@hcuge.ch.
authors.forename: Frank
authors.initials: F
authors.lastname: Schwenter
authors.forename: Pascal
authors.initials: P
authors.lastname: Gervaz
authors.forename: Philippe
authors.initials: P
authors.lastname: de Saussure
authors.forename: Thomas
authors.initials: T
authors.lastname: McKee
authors.forename: Philippe
authors.initials: P
authors.lastname: Morel