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Published on: October 29, 2014
Ileal and Meckel Diverticulum Adenomyomas: Two Pediatric Case Reports and Literature Review
Mário Rui Correia1, Diana A Baptista2,3, Sofia Pedrosa2,3
1Department of Pediatric Surgery, Centro Hospitalar Universitário de Santo António, Unidade Local de Saúde de Santo António, Porto, Portugal.
Insights
Small bowel adenomyomas are rare causes of intussusception in children. Histopathology confirmed these benign lesions, with one occurring in a Meckel diverticulum, highlighting the need for surgical diagnosis and treatment.
Area of Science:
- Gastroenterology
- Pediatric Surgery
- Surgical Pathology
Background:
- Adenomyomas are uncommon benign gastrointestinal lesions, typically found in the biliary tract and stomach.
- Small bowel adenomyomas are exceptionally rare, especially in pediatric populations.
- This report details two pediatric cases of small bowel adenomyomas, one within a Meckel diverticulum.
Purpose of the Study:
- To report two rare pediatric cases of small bowel adenomyomas.
- To emphasize the role of adenomyomas as pathological lead points in intussusception.
- To contribute to the understanding of adenomyomas within Meckel diverticula in children.
Main Methods:
- Case report methodology detailing two pediatric patients.
- Surgical exploration and excision of the lesions.
- Histopathological examination for definitive diagnosis.
Main Results:
- Two pediatric patients presented with intussusception due to small bowel adenomyomas.
- One adenomyoma was identified within a Meckel diverticulum, serving as a lead point.
- Histopathology confirmed the diagnosis of adenomyoma, characterized by dilated glands and smooth muscle.
Conclusions:
- Small bowel adenomyomas should be considered in pediatric intussusception cases with a pathological lead point.
- Histopathological examination is crucial for diagnosing small bowel adenomyomas.
- Surgical excision is both diagnostic and curative for these rare lesions.
Abstract:
BackgroundAdenomyomas are rare benign lesions of the gastrointestinal tract, mostly found in the biliary tract and stomach. Their occurrence in the small bowel, particularly in children, is exceedingly rare. This report presents two pediatric examples of small bowel adenomyomas, including one within a Meckel diverticulum, a notably rare occurrence.Case Report 1An 11-month-old boy presented with intussusception. Surgical exploration revealed a pathologic lead point in the ileum.Case Report 2A 12-year-old boy also presented with intussusception. A Meckel diverticulum, acting as a lead point, was identified and excised. Histopathology of both lesions showed cystically dilated glands surrounded by smooth muscle bundles, consistent with adenomyoma, the second within the diverticulum's lesion.ConclusionSmall bowel adenomyomas, although rare, should be considered in intussusception with a pathological lead point. Both case reports highlight the importance of histopathological examination for diagnosis. This lesion within a Meckel diverticulum represents the fourth pediatric example ever reported, contributing valuable insight into the pathogenesis of this rare entity. Surgical excision remains both diagnostic and curative.
