Abstract:
Meckel`s diverticulum occurs clinically only while development of complications (peptic ulcer with probable
hemorrhage and centesis – 43%; bowel obstruction on the background of the bowel obstruction and introsusception - 25,3%; diverticulitis - 14%, urachal fistula – 3,4%) and is relatively rare. Torsion of the appendages
of the uterus takes the 5th place in the structure of urgent gynecological pathology and occurs in almost 3%
of girls. We introduce our own observation, which presents difficulties in the preoperative diagnostics of these
conditions.
Girl of 15 years old was hospitalized complaining on pain in the lower abdomen, diarrhea up to 3 times per
day. In the blood tests minor inflammatory changes were detected. While ultrasound the parovarian tubular
formation up to 7 cm long with signs of infiltrative changes from the right side was revealed, which did not allow
to exclude an isolated torsion of the fallopian tube. Diagnostic laparoscopy was performed, and it was detected
that the uterus and appendages were without signs of inflammation and of normal sizes. At a distance of 30 sm
from the ileocecal angle the phagedenic changed Meckel`s diverticula up to 7 sm long twisted at the base was
detected. Laparoscopic removal of the diverticulum and appendectomy were performed. The postoperative
period proceeded smoothly, the girl was discharged home in a satisfactory condition on the 6th day.
Conclusion: all girls with a clinical picture of the “acute abdomen” are advisable to perform diagnostic
laparoscopy regardless of the results of laboratory diagnostics and ultrasound. In most cases it is possible to
perform the curative stage of laparoscopy without conversion.
