Meckel’s diverticulum perforated by swallowed chicken bone in infant: A very rare finding

A male infant with 1-year-old suddenly developed abdominal cramps, greenish vomitus, with constipation for 10 days’ duration. The vomiting is green after each feeding. His past medical and surgical history was otherwise unremarkable. There is no previous history of foreign body ingestion. On physical examination, the child was ill, dehydrated, in pain, with tachycardia (H.R. 155 B/M); normal respiratory rate and temperature was 38.8 C with 100% oxygen saturation. His abdomen was moderately distended and tender on palpation. Erect abdominal X-ray with dilatation of loops of bowel and multiple air-fluid levels. Ultrasound of the abdomen with free fluid in the pelvic cavity. Laboratory workup revealed a high leucocyte count (19.000), hyponatremia, and hypokalaemia. The first diagnosis was of bowel obstruction. The infant was kept nil per oral. He received an intravenous fluid and electrolytes for resuscitation. A nasogastric tube was inserted. Surgical exploration was done in the operating theatre through a supraumbilical transverse incision; we found a swallowed chicken bone that impacted Meckel’s diverticulum and caused perforation.The surgery was done under general anesthesia by resection of diverticulum, removal of impacted bone, and appendectomy. The perforated chicken bone has been removed. A drain was left in the pelvic cavity.