Symptomatic mesenteric Meckel's diverticulum in a toddler

Abstract

Meckel diverticulum is usually located at the antimesenteric aspect of the small intestine. It is very rare to arise from the mesenteric border near the blood supply. In literature, 13 cases of mesenteric Meckel diverticulum (MMD) were reported in the pediatric population. A 2-year 7-month-old boy was brought to the clinic with a history of recurrent, painless per rectal bleeding over the past year. Upon review, there are no other associated symptoms or signs. Following a systematic approach, all lab and radiological assessments were negative. Further upper and lower endoscopies were also normal. Technetium-99 m scintigraphy scan revealed a focus of rising uptake tracer in the middle of abdomen suggesting gastric ectopia. Diagnostic laparoscopy showed an unexpected mesenteric Meckel diverticulum which is exteriorized through an extended umbilical incision and resected extracorporeally along with primary anastomosis. The postoperative course was uneventful. The mesenteric Meckel diverticulum is a very rare entity, but it is more serious due to closity to the blood vessels of the bowel. So, even when it is asymptomatic and discovered incidentally it should be excised to avoid complications. The laparoscopic-assisted approach is a fast and straightforward method to diagnose and treat many intra-abdominal lesions in the pediatric population.