Introduction: Meckel’s Diverticulum (MD) is the most common congenital anomaly of gastrointestinal tract due to incomplete obliteration or persistence of proximal part of the Vitello intestinal tract. Perforation of Meckel’s diverticulum could be a rare but life-threatening complication as it can lead to generalized peritonitis which may progress to sepsis. Cases of perforation due to foreign bodies are reported with fish bone being the most common, but a perforation with a sugar cane fiber was not found in the literature reviewed.

Case presentation: Most patients with MD will be asymptomatic however when symptoms occur, they often mimic acute appendicitis. A 36-year-old lady presented with periumbilical and right iliac fossa pain with examination revealing RIF tenderness with normal inflammatory markers and an ultrasound scan finding of a prominent appendix and fluid filled cecum. She underwent a diagnostic laparoscopy which revealed a perforated Meckel’s diverticulum with a foreign body which was a sugar cane fiber. The histology revealed dual pathology of appendix with peri appendicitis and Meckel’s diverticulum with pancreatic tissue within it.

Conclusion: This case emphasizes on diagnostic difficulty and need of early intervention in cases of complicated Meckel’s diverticulum. Perforation of a Meckel’s diverticulum with a foreign body is rare but potentially life threatening and requires early recognition to avoid high morbidity. Resection is the main mode of management for complicated MD and that for uncomplicated depend on each case.