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An Unusual Case of a Perforated Meckel's Diverticulum
Lybil Mendoza Alvarez1, Dhanashree Rajderkar2, Genie L Beasley3
1University of Tennessee Health Science Center Pediatric Gastroenterology, Memphis, TN, USA.
Insights
Meckel's diverticulum, a common congenital anomaly, can rarely cause intestinal perforation in children. This case highlights the importance of considering Meckel's diverticulum in pediatric patients with symptoms mimicking inflammatory bowel disease.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Congenital Anomalies
Background:
- Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract.
- It typically presents in children with gastrointestinal bleeding.
Observation:
- An 11-year-old male presented with abdominal pain, vomiting, and diarrhea.
- He had iron deficiency anemia, elevated inflammatory markers, and imaging suggestive of bowel perforation.
Findings:
- The patient's symptoms were initially evaluated as infectious etiologies and inflammatory bowel disease.
- A Meckel's diverticulum was ultimately diagnosed, successfully resected, and resolved his symptoms.
Implications:
- This case highlights intestinal perforation as a rare presentation of Meckel's diverticulum in children.
- Clinicians should consider Meckel's diverticulum in the differential diagnosis for pediatric patients with overlapping symptoms of inflammatory bowel disease.
Background:
Meckel's diverticulum, the most common congenital anomaly of the gastrointestinal tract, typically presents in children with gastrointestinal bleeding. Case Presentation. An 11-year-old Caucasian male presented with a 6 week history of abdominal pain, vomiting, and diarrhea. He was found to have iron deficiency anemia, markedly elevated serum and fecal inflammatory markers, and imaging showing a contained bowel perforation. He was evaluated for infectious etiologies and later underwent extensive testing for inflammatory bowel disease. Ultimately, he was found to have a Meckel's diverticulum, which was successfully resected and led to resolution of his gastrointestinal complaints.
Conclusions:
This case report highlights one of the more rare presentations in children, which is intestinal perforation. Symptoms of a Meckel's diverticulum can overlap with those of inflammatory bowel disease, as demonstrated by our patient. Clinicians should be familiar with criteria to establish diagnosis of inflammatory bowel disease, and if diagnosis isn't fully supported by testing, they should expand the differential and consider Meckel's diverticulum.
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