Perforated Meckel's Diverticulum in a 22-Year-Old Male: A Case Report.

Meckel's diverticulum (MD), the most common congenital anomaly of the gastrointestinal tract, results from incomplete regression of the vitelline duct. Although often asymptomatic, complications occur in 4%-7% of cases, with perforation being a rare but life-threatening presentation that may mimic other acute abdominal emergencies. A 22-year-old Pakistani male was discovered with progressive abdominal pain, high-grade fever, vomiting, and diarrhea. Clinical findings and radiographic evidence of pneumoperitoneum suggested enteric perforation. An exploratory laparotomy incidentally revealed a perforated MD located 60 cm proximal to the ileocecal junction. Diverticulectomy with limited small bowel resection was performed, and histopathology confirmed a true diverticulum without ectopic mucosa. The postoperative course was uneventful. This case draws attention to the diagnostic challenge of MD perforation, which may masquerade as other surgical emergencies. Early recognition and prompt surgical intervention are crucial for preventing morbidity, underscoring the need to consider perforated MD in young adults presenting with an acute abdomen.