Abstract
Background
Abdominal pain is a common presenting symptom with a broad array of potential etiologies.
Meckel diverticulum (MD), the most common congenital gastrointestinal malformation,
classically presents with painless gastrointestinal bleeding. However, it can also
lead to diverticulitis, intussusception, or obstruction, manifesting as abdominal
pain.
Case Report
A 2-year-old boy presented to the emergency department with intermittent abdominal
pain, vomiting, and loose stools. Abdominal ultrasound findings were consistent with
ileitis and ileocolic intussusception, but no such intussusception was seen during
fluoroscopic air enema. The patient was admitted for serial abdominal examinations
and subsequently developed an acute abdomen. Emergent laparotomy revealed a perforated
MD. Small bowel resection and primary anastomosis were performed and no complications
developed.
Why Should an Emergency Physician Be Aware of This?
The presence of an MD can lead to diverticulitis, intussusception, or obstruction,
putting the patient at risk of bowel perforation. As such, it is important to consider
MD in the differential diagnosis of patients with abdominal pain. In cases in which
sonographic findings are ambiguous or transient, additional observation or alternative
imaging, such as computed tomography, should be strongly considered.
Keywords
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Article info
Publication history
Published online: April 19, 2020
Accepted:
March 18,
2020
Received in revised form:
February 25,
2020
Received:
January 12,
2020
Footnotes
Reprints are not available from the authors.
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
