Case Report: Complicated Meckel Diverticulum Spectrum in Children

Abstract

Background: Meckel diverticulum (MD) is the most common congenital anomaly of the intestines, with an incidence of 2% of the general population. It can present as various clinical features with complications and be life threatening if diagnosis is delayed and treatment late.Case Presentation: We report three pediatric cases with complicated MD: one female presented with small-bowel obstruction, one male with peritonitis, and one female with severe iron-deficiency anemia, without gross gastrointestinal bleeding nor any ectopic gastric mucosa. All patients underwent exploratory laparotomy, segmental small-bowel resection, and primary anastomosis. They successfully recovered and were uneventfully discharged on the fourth, seventh, and 10th postoperative days, respectively.Conclusions: MD can present with various complication spectrums, including small-bowel obstruction, peritonitis, and severe iron-deficiency anemia, which may cause difficulty in definitive diagnosis, particularly in children. Segmental small-bowel resection and primary anastomosis are effective surgical approaches and show good outcomes for MD patients.

Meckel's diverticulum causing acute intestinal obstruction: A case report and comprehensive review of the literature

“…The literature search in our search was conducted using the terms(s): “small bowel obstruction” AND “meckel's diverticulum” OR “diverticulitis” OR “volvulus” OR “intussusception”. The symptomatology, imaging findings, treatment employed, and the follow-up are delineated by Table 1 below [ [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] ].…”

“…No transition point was seen on the CT scan Exploratory laparotomy Alive, no complications Segment of the terminal ileum containing the MD and adhesion band was resected and stapled anastomosis with linear staples was performed Colicky central abdominal pain associated with loss of appetite and nausea. Luu et al [ 19 ] 2016 34 NA CT of Abd and pelvis Dilated small bowel loops & non-propulsive peristalsis and small bowel obstruction in the right lower abdominal quadrant Ileo-ileostomy Alive and well Incision of the small intestine and resection of ileum Abd pain, nausea, vomiting Ying et al [ 20 ] 2020 50 M CT of Abd and pelvis Several distended and fluid-filled small bowel loops throughout the abdomen with a transition point within the right lower quadrant suggestive of adhesions Laparotomy Alive and no issues on follow up in outpatient clinic Scarred section of MD and the adjacent small bowel segment was resected, and a side-to-side hand-sewn anastomosis was proceeded Abd pain, nausea, vomiting Jabri et al [ 21 ] 2012 26 M CT of Abd and Abd x-ray dilated loops of small bowel, with no free air under either diaphragm Laparotomy Alive and recovered IV and resection of the MD with closure of the bowel was performed and contents of small bowel were drained into stomach Abd pain, nausea, vomiting Gunadi et al [ 22 ] 2021 0.16 F Abd x-ray Small-bowel obstruction Exploratory laparotomy Alive and gradual recuperation Segmental small-bowel resection with primary anastomosis …”