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Uncommon presentation of Meckel's diverticulum in a child with decompensated hypovolemic shock
Nihan Şık1, Aslıhan Uzun2, Ali Öztürk1
1Division of Pediatric Emergency Care, Department of Pediatrics, Dokuz Eylül University Faculty of Medicine, İzmir-Türkiye.
Abstract:
Meckel's diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract and may cause serious complications such as intestinal obstruction, gastrointestinal hemorrhage, or inflammation with/without perforation, which can present with non-spe-cific symptoms and signs. We report on the case of a 2.5-year-old boy admitted to our emergency department in poor condition, with compatible signs of decompensated hypovolemic shock. This case finally resulted in intestinal volvulus and internal hernia, a very rare combination of two complications of MD, as determined in the operating room.
Insights
Meckel's diverticulum (MD) is a common congenital anomaly that can lead to severe complications. This case highlights a rare combination of intestinal volvulus and internal hernia secondary to MD in a pediatric patient.
Area of Science:
- Pediatric Surgery
- Gastrointestinal Anomalies
- Surgical Case Reports
Background:
- Meckel's diverticulum (MD) is the most frequent congenital abnormality of the small intestine.
- MD complications, including obstruction, hemorrhage, and inflammation, often present with non-specific symptoms.
- Early diagnosis and management are crucial for preventing severe outcomes.
Observation:
- A 2.5-year-old boy presented with signs of decompensated hypovolemic shock.
- The patient's condition suggested a critical intra-abdominal event.
- Emergency surgical intervention was deemed necessary.
Findings:
- The patient was diagnosed intraoperatively with a rare combination of intestinal volvulus and internal hernia.
- Both complications were found to be secondary to Meckel's diverticulum.
- The complexity of the presentation underscored the potential severity of MD.
Implications:
- This case emphasizes the importance of considering Meckel's diverticulum in pediatric patients with non-specific abdominal symptoms and shock.
- The rare co-occurrence of volvulus and internal hernia highlights the diverse and severe complications MD can precipitate.
- Awareness of such rare presentations is vital for timely surgical intervention and improved patient outcomes in pediatric gastrointestinal surgery.
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