Meckel's Diverticulum, A Rare Presentation in a Neonate.

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Neonatal Medicine

Background:

• Meckel's diverticulum is a congenital anomaly frequently causing complications like gastrointestinal bleeding or obstruction within the first two years of life.
• Common causes of symptomatic Meckel's diverticulum include incarcerated inguinal hernias or ileocolic intussusception, leading to obstruction and hematochezia.

Observation:

• A 5-day-old male infant presented with bright red blood per rectum and emesis.
• Initial examination revealed normal vital signs and a non-distended abdomen, but serial radiographs showed progressive small bowel distention and air-fluid levels.

Findings:

• Operative intervention diagnosed intestinal obstruction due to a 24 cm fibrosed, ischemic, closed-loop ileal segment.
• This segment was densely adhered to the tip of a Meckel's diverticulum, which was resected with primary reanastomosis.
• Histological examination confirmed the presence of ectopic gastric tissue within the diverticulum.

Implications:

• This case highlights a unique presentation of Meckel's diverticulum causing a closed-loop small bowel obstruction in a neonate.
• The findings expand the spectrum of known complications associated with Meckel's diverticulum, emphasizing the need for early diagnosis and surgical management in neonates.
• This report contributes novel insights into the pathophysiology of Meckel's diverticulum-related neonatal intestinal obstruction.