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Meckel's Diverticulum, A Rare Presentation in a Neonate

Jesse Honig1, Ariel Figueroa2, Rebecca Castro1

  • 1Departments of Surgery and Pediatrics, New York City Health+ Hospitals, New York Medical College Academic, Valhalla, NY, USA.

The American Surgeon
|March 18, 2022
PubMed

Insights

A rare case of Meckel's diverticulum caused a small bowel obstruction in a 5-day-old infant. This presentation, involving a closed-loop ileal segment, has not been previously reported in medical literature.

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.

Keywords:
Meckel’s diverticulumcase reportclosed-loop bowel obstructionneonatologysmall bowl resection

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