Perforated Meckel's Diverticulum With Dual Gastric and Pancreatic Heterotopia: A Pediatric Case Report

Meckel's diverticulum is a common congenital gastrointestinal anomaly that can lead to life-threatening complications such as perforation. While rare in children, a perforated Meckel's diverticulum often mimics acute appendicitis, posing a significant diagnostic challenge. We report the case of a five-year-old male who presented with acute right lower quadrant pain, hematochezia, vomiting, and signs of peritonitis. Emergency laparotomy was performed, which confirmed a perforated Meckel's diverticulum densely adherent to the ascending colon. Histopathological examination of the resected specimen revealed the presence of dual heterotopic tissue, consisting of both gastric and pancreatic mucosa, with transmural necrosis at the site of perforation. The patient had an uneventful postoperative recovery. This case underscores the necessity of considering Meckel's diverticulum in the differential diagnosis of a pediatric acute abdomen, especially when atypical symptoms like rectal bleeding are present. It further highlights the role of histopathology in identifying dual heterotopia as a predisposing factor for perforation.