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Case Report: Complicated Meckel Diverticulum Spectrum in Children
Gunadi1, Wahyu Damayanti2, Robin Perdana Saputra1
1Pediatric Surgery Division, Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, Indonesia.
Insights
Meckel diverticulum (MD) can cause serious complications like bowel obstruction, peritonitis, and anemia in children. Surgical resection and anastomosis offer effective treatment for complicated MD.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Congenital Anomalies
Background:
- Meckel diverticulum (MD) is a common congenital intestinal anomaly affecting 2% of the population.
- MD complications can be life-threatening if diagnosis and treatment are delayed.
- Pediatric cases highlight the diverse and challenging presentations of MD.
Observation:
- Three pediatric patients presented with complicated Meckel diverticulum.
- Presentations included small-bowel obstruction, peritonitis, and severe iron-deficiency anemia.
- One case of anemia occurred without overt gastrointestinal bleeding or ectopic gastric mucosa.
Findings:
- All patients underwent successful exploratory laparotomy, segmental small-bowel resection, and primary anastomosis.
- Surgical outcomes were favorable, with patients discharged on postoperative days 4, 7, and 10.
- MD's varied presentations can complicate diagnosis in children.
Implications:
- Meckel diverticulum requires prompt diagnosis and management due to its potential for severe complications.
- Segmental small-bowel resection with primary anastomosis is an effective surgical strategy for complicated MD.
- Awareness of MD's diverse clinical spectrum is crucial for pediatricians and surgeons.
Abstract:
Background: Meckel diverticulum (MD) is the most common congenital anomaly of the intestines, with an incidence of 2% of the general population. It can present as various clinical features with complications and be life threatening if diagnosis is delayed and treatment late. Case Presentation: We report three pediatric cases with complicated MD: one female presented with small-bowel obstruction, one male with peritonitis, and one female with severe iron-deficiency anemia, without gross gastrointestinal bleeding nor any ectopic gastric mucosa. All patients underwent exploratory laparotomy, segmental small-bowel resection, and primary anastomosis. They successfully recovered and were uneventfully discharged on the fourth, seventh, and 10th postoperative days, respectively. Conclusions: MD can present with various complication spectrums, including small-bowel obstruction, peritonitis, and severe iron-deficiency anemia, which may cause difficulty in definitive diagnosis, particularly in children. Segmental small-bowel resection and primary anastomosis are effective surgical approaches and show good outcomes for MD patients.
