Meckel Diverticulitis with Acute Intestinal Obstruction in a 2-Month-Old Infant: a Case Report

Among the complications of Meckel diverticulum, the most commonly diagnosed are acute intestinal obstruction and diverticulitis. In infants, these pathological conditions are rare, and their combination has been reported only in isolated cases. Therefore, the present clinical observation is of interest to pediatric surgeons. A 2-month-old girl was transferred from a district hospital to the surgical department of a general hospital 20 hours after disease onset, presenting with signs of an acute abdomen, including recurrent vomiting, intermittent restlessness, abdominal distention, absence of stool, and fever. Ultrasound and radiography revealed multiple fluid levels and peritoneal effusion, indicating signs of intestinal obstruction. Following preoperative preparation, a laparotomy was performed through a right transrectal incision. In the abdominal cavity, turbid effusion and a distended, hyperemic, and edematous ileal loop were identified, compressed by a fibrous band extending from the root of the mesentery to the Meckel diverticulum. The diverticulum had a wide base and was located 30 cm from the ileocecal angle, phlegmonously altered. The fibrous band was excised, restoring intestinal patency. The strangulated intestinal loop was found to be viable. A wedge resection of the diverticulum was performed, followed by abdominal cavity sanitation. Diagnosis: Strangulated obstruction of the ileum, phlegmonous diverticulitis. The postoperative course was uneventful. The infant was discharged from the hospital in satisfactory condition. This clinical case illustrates the possibility of acute pathological conditions uncommon in infants and highlights the importance of early hospitalization in specialized pediatric surgical units when an acute abdominal syndrome is suspected.