Meckel's diverticulum presenting as fistula-in-ano

A rare complication of Meckel's diverticulum: a fistula between Meckel's diverticulum and the appendix

Meckel diverticulum is the most common congenital anomaly of the small intestine, occurring in about 2%-4% of the population. Meckel diverticulum results from incomplete closure of the omphalomesenteric duct. The presentation of symptomatic Meckel diverticulum includes gastrointestinal hemorrhage, intestinal obstruction, volvulus, intussusception, diverticulitis, and neoplasms. The development of fistula is an extremely rare complication. Previous literature has even shown an enterocolonic fistula, a vesicodiverticular fistula, ileorectal fistula, and fistula-in-ano. To the best of our knowledge, we present the first case of the fistula complicated between Meckel diverticulum and the appendix in a review of the English literature.

Enterovesical fistula from Meckel's diverticulum in a patient with Crohn's ileitis

Formation of a fistula from a Meckel's diverticulum to the bladder is extremely rare and may not be recognized, especially in patients with other gastrointestinal disease. We describe a patient with Crohn's ileitis who was assumed to have two enterovesical fistulae from his diseased ileum. Laparotomy revealed a Meckel's diverticulum with fistulization to the bladder. The diverticulum contained inflamed and ulcerated ectopic gastric mucosa but was not affected by Crohn's disease. We know of only one other report of an enterovesical fistula resulting from a Meckel's diverticulum. In that case, however, the diverticulum did not contain ectopic tissue.