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

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Title: Meckel's diverticulum with intraperitoneal hemorrhage in a child detected with screening laparoscopy: a case report
Authors: Wakizaka, Kazuki Browse this author
Khor, Lee Wee Browse this author
Annen, Kazuya Browse this author
Fukushima, Tsuyoshi Browse this author
Furuya, Mitsuko Browse this author
Taketomi, Akinobu Browse this author →KAKEN DB
Keywords: Meckel's diverticulum
Intraperitoneal hemorrhage
Laparoscopic surgery
Case report
Issue Date: 2022
Publisher: Springer
Journal Title: Surgical case reports
Volume: 7
Issue: 1
Start Page: 264
Publisher DOI: 10.1186/s40792-021-01347-9
Abstract: Background The 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 presentation An 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. Conclusions We 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.
Type: article
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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