Intussusception secondary to a double Meckel's diverticulum in a 2-month-old infant: a case report

Introduction

Double Meckel's diverticulum is extremely rare. Only five cases have been reported in the pediatric population, none of which were associated with intestinal intussusception.

Case presentation

A 2-month-old, full-term infant born at 37 weeks of gestation was admitted with a one-day history of vomiting and blood-streaked stool. Laboratory tests were within normal limits. Abdominal x-ray showed distended bowel loops. Abdominal ultrasound showed findings suggestive of an Ileocolic intussusception. Due to the duration of symptoms, an enema reduction was not attempted. He was taken to the operating room for an exploratory laparoscopy. We used a single-port technique through a small incision at the umbilicus. We found an ileo-ileal intussusception and exteriorized the involved segment through the umbilical incision. The intussusception was manually reduced, and we found two Meckel's diverticula on the antimesenteric border of the affected segment, one measuring 1.5 cm by 2 cm, and the other one 1 cm by 1 cm. The larger one served as the leading point for the intussusception. We resected the affected segment that included the two diverticula and did a primary anastomosis. Because the bowel was somewhat compromised, we planned to do a second look. The patient remained the intermediate care unit, extubated. We took him back to the operating room 72 hours later and confirmed that the anastomosis was intact. He resumed enteral feedings three days after the last operation and was discharged home two days later. The pathological examination confirmed two true Meckel's diverticula with no evidence of heterotopic gastric mucosa.

Conclusion

Patients who are found to have a Meckel's diverticulum should have their entire small bowel inspected to rule out a second Meckel's diverticulum, which although rare, has been reported.