Spontaneously perforated Meckel's diverticulum: a rare cause of neonatal acute abdomen

Meckel's diverticulum, a congenital gastrointestinal malformation, is seldom detected in the neonatal age group. Here, we present a neonate who presented to us with respiratory distress and acute abdomen. An X-ray showed pneumoperitoneum. Exploratory laparotomy revealed perforation at the tip of Meckel's diverticulum with faecal peritonitis. Wedge resection and anastomosis were performed. There were no heterotopic or dysplastic tissues. The baby improved and was discharged on exclusive breastfeeding. This case highlights a rare condition, which is rarely symptomatic, particularly in the neonatal period. While the most common clinical presentations include intestinal obstruction, inflammation or bleeding, our patient presented with a spontaneous perforation of the diverticulum in the absence of any clear predisposing risk factors. This case highlights the importance of a high index of suspicion in cases of sudden acute abdomen, as prompt diagnosis and management may have a good outcome.