Meckel’s diverticulum with intraperitoneal hemorrhage in a child detected with screening laparoscopy: a case report

Surgical Case Reports

Akinobu Taketomi¹  Lee Wee Khor²  Kazuya Annen²  Tsuyoshi Fukushima²  Kazuki Wakizaka²  Mitsuko Furuya³ 

[1] Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, N15-W7, Kita-ku, 060-8638, Sapporo, Hokkaido, Japan;Department of Surgery, Chitose City Hospital, 2-2-1, Hokko, 066-8550, Chitose, Hokkaido, Japan;Pathology Center, GeneticLab Co., Ltd., 28-196, N9-W15, Chuo-ku, 060-0009, Sapporo, Hokkaido, Japan;

关键词: Meckel’s diverticulum;    Intraperitoneal hemorrhage;    Laparoscopic surgery;    Pediatric;    Case report;   

DOI  :  10.1186/s40792-021-01347-9

来源: Springer

【 摘 要 】

BackgroundThe most common presentation of symptomatic Meckel’s diverticulum (MD) are intestinal obstruction, gastrointestinal hemorrhage, and inflammation of the MD with or without perforation. Intraperitoneal hemorrhage because of MD is extremely rare. We report a case of MD with intraperitoneal hemorrhage in a child detected with screening laparoscopy.Case presentationAn 11-year-old girl presented to another hospital with lower abdominal pain and vomiting that lasted for 2 days. Acute appendicitis was suspected, and she was referred to our department. Abdominal enhanced computed tomography showed an abscess in the lower abdomen with ascites in the pelvis. She was diagnosed with a localized intra-abdominal abscess and the decision was made to treat with antibiotics. However, her abdominal pain worsened, with abdominal distension, tenderness and guarding. She was diagnosed with panperitonitis and the decision was made for surgery 5 h after admission. During surgery, laparoscopic observation from the umbilical region revealed 200 ml of fresh blood throughout the peritoneal cavity, originating from the mesentery of the ileum. MD was observed with bleeding from the surrounding mesentery. Small bowel resection was performed, and the patient was discharged on the 5th postoperative day. Pathological findings revealed an MD containing ectopic gastric mucosa and small intestinal ulcer perforation at the base of the MD.ConclusionsWe report an extremely rare case of an MD with intraperitoneal hemorrhage in a child. In pediatric cases, it is possible that perforation with ectopic gastric mucosa may cause massive bleeding because of rupture of the surrounding mesenteric blood vessels.

【 授权许可】

CC BY