Unique presentation of a ruptured Meckels diverticulum after blunt trauma

Description 

A 25-year-old man with no significant medical or surgical history presented with a complaint of thick, dark drainage from a periumbilical wound for 1 month (figure 1). He reported first noticing the drainage several days after bumping into the corner of a machine at work. He was seen by his primary care physician and prescribed oral antibiotics for persistent drainage and erythema; however, his symptoms failed to improve.

Figure 1

Chronic umbilical wound sustained after blunt abdominal trauma, with drainage of a thick, dark fluid for 1 month.

On presentation to the emergency department, the patient was afebrile and haemodynamically stable. Lab work was within normal limits. An abdominal CT scan demonstrated a loculated periumbilical fluid collection, with extension intraperitoneally into a portion of thickened small bowel with suspicion of an enterocutaneous fistula (figure 2).

Figure...

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