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Meckel's diverticulum mimicking infantile colic: sonographic detection
1Department of Pediatrics, Chang Gung Memorial Hospital at Kaohsiung, Taiwan.
Insights
A perforated Meckel's diverticulum mimicked infantile colic in an infant. Surgical resection revealed a sealed perforation forming an inflammatory mass, highlighting a rare cause of chronic infant distress.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Diagnostic Imaging
Background:
- Meckel's diverticulum is a congenital anomaly of the small intestine.
- It is the most common congenital malformation of the gastrointestinal tract.
- Complications include obstruction, bleeding, and intussusception, but presentation as a chronic inflammatory mass is rare.
Observation:
- A 6-month-old infant presented with 5 months of chronic screaming, initially diagnosed as infantile colic.
- Abdominal sonography revealed an anechoic cystic mass.
- CT and barium enema showed nonspecific findings of a cystic mass compressing adjacent bowel.
Findings:
- Histologic examination of the resected mass confirmed a Meckel's diverticulum.
- The diverticulum had a sealed perforation, forming an inflammatory mass with surrounding bowel and mesentery.
- This presentation is an unusual manifestation of Meckel's diverticulum.
Implications:
- This case underscores the importance of considering Meckel's diverticulum in the differential diagnosis of unexplained chronic infant distress, even without overt signs of obstruction.
- Advanced imaging and surgical exploration may be necessary for definitive diagnosis.
- Early diagnosis and surgical intervention are crucial for favorable outcomes in pediatric surgical emergencies.
Abstract:
We report a case of Meckel's diverticulum in a 6-month-old girl who presented with a 5-month history of chronic screaming but no symptoms or signs of intestinal obstruction. Infantile colic was the presumptive diagnosis. Abdominal sonography at 6 months of age demonstrated an abdominal mass with an anechoic center and a double-layered wall, surrounded by bowel loops. Abdominal CT and barium enema x-ray studies demonstrated nonspecific findings of a cystic mass with compression of adjacent bowel loops. Histologic examination of the resected mass revealed a Meckel's diverticulum with a perforation sealed off by the neighboring bowel and mesentery to form an inflammatory mass.