Sun YM, Xin W, Liu YF, Guan ZM, Du HW, Sun NN, Liu YD. Appendicitis combined with Meckel’s diverticulum obstruction, perforation, and inflammation in children: Three case reports. World J Clin Cases 2024; 12(4): 865-871 [PMID: 38322683 DOI: 10.12998/wjcc.v12.i4.865]
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Feb 6, 2024; 12(4): 865-871 Published online Feb 6, 2024. doi: 10.12998/wjcc.v12.i4.865
Appendicitis combined with Meckel’s diverticulum obstruction, perforation, and inflammation in children: Three case reports
Yi-Meng Sun, Wang Xin, Yu-Fang Liu, Zhe-Ming Guan, Hao-Wen Du, Ning-Ning Sun, Yong-Dong Liu
Yi-Meng Sun, School of Clinical Medicine, Weifang Medical University, Weifang 261000, Shandong Province, China
Wang Xin, Zhe-Ming Guan, Hao-Wen Du, Ning-Ning Sun, Yong-Dong Liu, Department of Pediatric Surgery, Weifang People’s Hospital, Weifang 261000, Shandong Province, China
Yu-Fang Liu, Department of Burn Surgery, Weifang People’s Hospital, Weifang 261000, Shandong Province, China
Author contributions: Sun YM reviewed the literature, and contributed to manuscript drafting; Xin W, Liu YF and Guan ZM contributed to manuscript drafting; Du HW and Sun NN obtained informed consent; Liu YD was responsible for the revision of the manuscript; all authors gave final approval for the submitted version.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Received: November 26, 2023 Peer-review started: November 26, 2023 First decision: November 30, 2023 Revised: December 6, 2023 Accepted: January 8, 2024 Article in press: January 8, 2024 Published online: February 6, 2024
Abstract
BACKGROUND
Meckel’s diverticulum is a common congenital malformation of the small intestine, with the three most common complications being obstruction, perforation, and inflammation. To date, only a few cases have been reported worldwide. In children, the clinical symptoms are similar to appendicitis. As most of the imaging features are nonspecific, the preoperative diagnosis is not precise. In addition, the clinical characteristics are highly similar to pediatric acute appendicitis, thus special attention is necessary to distinguish Meckel’s diverticulum from pediatric appendicitis. Patients with poor disease control should undergo laparoscopic exploration to avoid serious complications, including intestinal necrosis, intestinal perforation and gastrointestinal bleeding.
CASE SUMMARY
This report presents three cases of appendicitis in children combined with intestinal obstruction, which was caused by fibrous bands (ligaments) arising from the top part of Meckel's diverticulum, diverticular perforation, and diverticular inflammation. All three patients, aged 11-12 years, had acute appendicitis as their initial clinical presentation. All were treated by laparoscopic surgery with a favorable outcome. A complete dataset including clinical presentation, diagnostic imaging, surgical information, and histopathologic findings was also provided.
CONCLUSION
Preoperative diagnosis of Meckel’s diverticulum and its complications is challenging because its clinical signs and complications are similar to those of appendicitis in children. Laparoscopy combined with laparotomy is useful for diagnosis and treatment.
Core Tip: Meckel's diverticulum is a congenital disorder with abnormal development of the gastrointestinal tract, which is easily confused with the clinical manifestations of acute abdominal conditions in children. We report three cases of acute appendicitis combined with Meckel's diverticulum causing obstruction, perforation, and inflammation. This disease is rare and is easily confused with appendicitis. In Meckel's diverticulum, laparoscopic surgery can diagnose and resolve the disorder. The differential diagnosis of acute appendicitis in children is of high educational and clinical importance.
