TY - JOUR
T1 - Meckel Diverticulum Presenting as Abdominal Pain and Subsequent Bowel Perforation
AU - LaFlam, Taylor N.
AU - Phelps, Andrew
AU - Choi, Won Tak
AU - Kornblith, Aaron E.
N1 - Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2020/6
Y1 - 2020/6
N2 - 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.
AB - 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.
KW - Meckel diverticulum (complications)
KW - Meckel diverticulum (diagnosis)
KW - abdominal pain
KW - bowel perforation
KW - pediatrics
UR - http://www.scopus.com/inward/record.url?scp=85083319202&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85083319202&partnerID=8YFLogxK
U2 - 10.1016/j.jemermed.2020.03.019
DO - 10.1016/j.jemermed.2020.03.019
M3 - Article
C2 - 32317193
AN - SCOPUS:85083319202
SN - 0736-4679
VL - 58
SP - e251-e254
JO - Journal of Emergency Medicine
JF - Journal of Emergency Medicine
IS - 6
ER -