LAUSR

With a prevalence of just 2%, Meckel’s diverticulum is still the most common congenital anomaly to affect the gastrointestinal tract. It is a true diverticulum formed by all layers of the small intestine resulting from the remnant of the vitelline duct. We present the case of a 34-year-old male with a history of eosinophilic oesophagitis who attended the Emergency Department following a nine hours of abdominal pain in the hypogastrium and right iliac fossa accompanied by nausea and vomiting, with no irregular bowel movements or fever. During the physical examination, the patient experienced pain upon palpation of this area with positive decompression. Blood tests were performed in the Emergency Department, finding leukocytosis of 14,800, neutrophilia of 12,400 and CRP of 23. An abdominal ultrasound was ordered, which revealed inflammation and free fluid in the ileal region. The study was completed with an abdominal CT scan, resulting in a diagnosis of ileitis and ruling out diseases of the appendix. Yersinia and Anisakis serology tests were also requested, both of which came back negative. Finally, a colonoscopy with ileoscopy was performed, finding no evidence of disease in the colon or in the last 15 cm of the terminal ileum. After empirical antibiotic therapy, the patient progressed favourably with reduced abdominal pain and diminished acute-phase reactants. As a result, he was discharged and scheduled for outpatient follow-up with a view to completing the ileitis assessment with capsule endoscopy or enteroscopy. However, he returned to the Emergency Department six hours later due to diffuse abdominal pain of an