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Internal hernia caused by Meckel diverticulum in an infant: report of one case
1Department of Pediatrics, Cathay General Hospital, 280, Section 4, Jen-Ai Road, Taipei, Taiwan.
Insights
Internal hernia through a Meckel diverticulum caused intestinal obstruction in a 10-month-old boy. This rare condition, often missed preoperatively, required exploratory surgery for diagnosis and treatment.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Medical Imaging
Background:
- Meckel diverticulum is a congenital anomaly of the small intestine.
- Internal hernias, particularly those involving Meckel diverticula, are rare causes of intestinal obstruction.
- Preoperative diagnosis of internal hernia secondary to Meckel diverticulum is challenging.
Observation:
- A 10-month-old boy presented with acute abdominal pain, persistent vomiting, and mild fever.
- Initial imaging studies including abdominal sonography, X-ray, and CT scan suggested mechanical ileus and partial malrotation.
- Diagnostic uncertainty persisted despite non-invasive imaging modalities.
Findings:
- Exploratory laparotomy was performed due to persistent symptoms and unclear diagnosis.
- The surgery revealed a Meckel diverticulum as the cause of internal hernia.
- Small bowel herniation through the mesodiverticulum of the Meckel diverticulum was confirmed.
Implications:
- This case highlights the importance of considering Meckel diverticulum and internal hernia in the differential diagnosis of intestinal obstruction in infants.
- Early surgical exploration may be necessary when imaging is inconclusive for pediatric intestinal obstruction.
- Understanding the pathophysiology of Meckel diverticulum-related internal hernias is crucial for timely intervention.
Abstract:
Intestinal obstruction caused by internal hernia due to Meckel diverticulum is a rare disease. The condition is seldom diagnosed preoperatively. In this paper, we present a 10-month-old boy who suffered from abdominal pain, persistent vomiting, and mild fever for 2 days. Abdominal sonography, plain abdomen X-ray, and computed tomography merely showed mechanical ileus and partial malrotation. However, exploratory laparotomy revealed a Meckel diverticulum through which the small bowel had herniated. We introduce the Meckel diverticulum and internal hernia and discuss intestinal obstructions.