Pneumoperitoneum in a Micro – Preemie due to Perforated Meckel’s Diverticulum

Le, Nhatrang; Alemayehu, Hanna; Singh, Vivekanand; Hendrickson, Richard J.

doi:10.21699/jns.v7i1.670

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“…Complications may occur in up to 4% of cases, and in the symptomatic, intestinal perforation is seen fewer than 10% of cases [ 1 ]. Diverticular length and base diameter are well-known predisposing factors to complications with long, narrow-based diverticula thought to predispose to obstruction on the basis of intussusception and inflammation [ 3 , 5 , 7 ]. Common manifestations of neonatal MD include perforation, intussusception, segmental ileal dilatation, and ileal volvulus [ 8 , 28 , 61 ].…”

Section: Discussionmentioning

confidence: 99%

Perforated Meckel’s diverticulum in neonates: a report of six cases and systematic review of the literature

et al. 2022

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Background Perforation of Meckel Diverticulum (MD) is a rare cause of pneumoperitoneum in neonates. We hereby report six cases of perforation of MD in neonates, with addition of 53 cases from systematic review of the literature. A systematic review was performed using Mesh terms “Neonate, Meckel Diverticulum, Perforation, Pneumoperitoneum.” All reports of perforated MD in the English literature were identified. Details of our 6 cases were analyzed in similar fashion. Results A total of 3027 manuscripts were screened and 59 cases including 6 of our own were identified. The vast majority (78%) were female. Fifty patients (84.7%) presented in the newborn period. Half of the cases (52.5%) had associated anomalies and 13 neonates (22%) required oxygen supplementation including CPAP or ventilatory support before surgery. In 73% of the cases, a resection of gut was undertaken. Histopathological assessment in 44 cases (74.6%) revealed no ectopic gastric mucosa. Three cases demised prior to treatment. The outcome in the vast majority was excellent with 84.7% surviving and discharged well. Conclusion Perforated MD is an unusual cause of a pneumoperitoneum in the newborns. Diagnosis is established at laparotomy and it rare to find ectopic mucosa histopathologically. The overall outcome is excellent.

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