Inverted Meckel’s diverticulum as a cause of intestinal intussusception in a child: A case report

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Abstract

One of the causes of intussusception is the presence of Meckel’s diverticulum. Although Meckel’s diverticulum is the most common anomaly of the gastrointestinal tract, isolated cases of intussusception caused by the inversion of Meckel’s diverticulum into the lumen of the ileum have been described in world literature. Description of case. The patient was a 2-year-11-month boy who was transported by an ambulance team, with complaints of paroxysmal abdominal pain and single vomiting. Palpation revealed lower abdominal pain without signs of peritoneal irritation. The child underwent an ultrasound examination of the abdominal cavity, which revealed a layered structure consisting of the wall of the large and small intestines in the right lower quadrant. Thus, a diagnosis of intussusception was established. An attempt to conservatively straighten the intussusception during pneumoirrigoscopy was ineffective. Emergency laparoscopy was performed, and ileocecal intussusception was diagnosed, which was eliminated without technical difficulties. During the inspection of the ileum, a crater-shaped depression with a dense formation extending from it into the intestinal lumen was discovered on its antimesenteric edge 30 cm from the ileocecal angle. The operation was continued with a minilaparotomy in the right iliac region. Meckel’s diverticulum was manually inverted from the ileum, tied at the base, and cut off with the stump immersed in a purse-string suture. The postoperative period was event-free. On day 5 after the operation, the child was discharged home in a satisfactory condition. For any intussusception in children aged >1 year, the anatomical causes must be excluded, except for the possibility of an inverted Meckel’s diverticulum. Therefore, after successful intestinal disinvagination, a thorough revision of the ileum is necessary.

About the authors

Madina A. Chundokova

Filatov Children’s Hospital; Pirogov Russian National Research Medical University

Author for correspondence.
Email: Cmadina@yandex.ru
ORCID iD: 0000-0002-5080-4838
SPIN-code: 1122-0394

MD, Dr. Sci. (Medicine), Associate Professor

Russian Federation, Moscow; Moscow

Maksim A. Golovanev

Filatov Children’s Hospital; Pirogov Russian National Research Medical University

Email: aesculap2001@mail.ru
ORCID iD: 0000-0002-5512-9894
SPIN-code: 4034-4303

MD, Cand. Sci. (Medicine), Associate Professor

Russian Federation, Moscow; Moscow

Andrey A. Ivanov

Pirogov Russian National Research Medical University

Email: 2a-iv80@mail.ru
ORCID iD: 0009-0000-7441-9005
SPIN-code: 9018-5150
Russian Federation, Moscow

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Supplementary files

Supplementary Files
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1. JATS XML
2. Fig. 1. Sonography in the transverse plane of the right lower abdominal quadrant revealed the typical “target sign” of intussusception

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3. Fig. 2. Ileocecal intussusception

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4. Fig. 3. Base of the inverted Meckel’s diverticulum on the free edge of the ileum

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5. Fig. 4. Minilaparotomy, stages of surgery: a — Meckel’s diverticulum in the ileum; b — Meckel’s diverticulum after disinvagination; c — view of the intestine after the removal of the diverticulum

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