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Meckel's diverticulum masked by a long period of intermittent recurrent subocclusive episodes

Daniela Codrich1, Andrea Taddio, Jurgen Schleef

  • 1Department of Pediatric Surgery, Institute of Child Health, IRCCS Burlo Garofolo, Trieste, Italy. codrich@yahoo.com

World Journal of Gastroenterology
|June 13, 2009
PubMed

Insights

Meckel's diverticulum, a common congenital small bowel issue, is often hard to diagnose. This case highlights its subtle presentation mimicking cyclic vomiting syndrome in a child.

Area of Science:

  • Gastroenterology
  • Pediatric Surgery
  • Congenital Abnormalities

Background:

  • Meckel's diverticulum (MD) is the most common congenital anomaly of the small intestine.
  • While often asymptomatic, MD can present with complications like bleeding, obstruction, or inflammation in about 4% of cases.
  • Diagnosis of MD can be challenging due to its varied and sometimes non-specific symptoms.

Observation:

  • A 7-year-old boy presented with a year-long history of recurrent periumbilical colicky pain and alimentary vomiting.
  • These symptoms were initially misdiagnosed as cyclic vomiting syndrome.
  • The underlying cause was eventually identified as Meckel's diverticulum.

Findings:

  • The case illustrates the diagnostic difficulties associated with Meckel's diverticulum.
  • Symptoms mimicking other common pediatric conditions can delay MD diagnosis.
  • A high index of suspicion and appropriate diagnostic methods are crucial for identifying MD.

Implications:

  • This case underscores the importance of considering Meckel's diverticulum in the differential diagnosis of recurrent abdominal pain and vomiting in children.
  • It highlights the need for thorough evaluation to avoid misdiagnosis and delayed treatment.
  • Understanding the diverse clinical presentations of MD is essential for pediatricians and surgeons.

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