Segmental dilatation of the ileum presenting with acute intestinal bleeding

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Pathology

Background:

• Segmental intestinal dilatation is a rare congenital anomaly.
• Acute intestinal bleeding in infants can be life-threatening.
• Meckel's diverticulum is a common cause of such bleeding, often leading to initial diagnostic suspicion.

Observation:

• A 5-month-old infant presented with profuse rectal bleeding and acute anemia (Hb 5.3 g/dL).
• Initial investigations, including plain X-ray, were normal, and symptoms mimicked a bleeding Meckel's diverticulum.
• Laparoscopy revealed segmental ileal dilatation as the source of bleeding.

Findings:

• Histopathological examination confirmed an ulcer within the dilated ileum.
• The ulcer was attributed to the presence of heterotopic gastric mucosa.
• This finding identified a rare cause of acute gastrointestinal hemorrhage in an infant.

Implications:

• Highlights the importance of considering segmental ileal dilatation in the differential diagnosis of infant gastrointestinal bleeding.
• Underscores the diagnostic value of laparoscopy in unclear cases of pediatric abdominal emergencies.
• Provides insight into the etiopathogenesis of this rare condition, linking it to heterotopic gastric mucosa.