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Symptomatic Meckel’s Diverticulum in Newborn: Two Interesting Additional Cases and Review of Literature

Bertozzi, Mirko MD*; Melissa, Berardino MD*; Radicioni, Maurizio MD; Magrini, Elisa MD*; Appignani, Antonino MD, PhD*

doi: 10.1097/PEC.0b013e3182a315e5
Illustrative Cases

Objectives This study aimed to review the literature about symptomatic Meckel’s diverticulum (MD) in the neonatal period with 2 additional uncommon cases.

Methods The authors describe 2 interesting neonatal cases of symptomatic MD and analyze the literature on this topic, with particular reference to the prevalence of sex, age at presentation, most common signs and symptoms, treatment, histology, associated anomalies, and outcome.

Results The first patient was a term newborn with bowel obstruction by a pseudocystic MD. The second patient was a preterm infant with double perforation of the MD and ileum. Literature search for published case reports and case series on this topic reveals only 18 cases of neonatal symptomatic MD. Males are more frequently involved than females, and even preterm infants may be affected. Bowel obstruction (58.3%) and pneumoperitoneum (33.3%) are the most frequent clinical manifestation. Acute inflammation of the MD is the prominent histopathological finding (75%), although it does not seem to be related with the presence of heterotopic tissue within the MD. Surgical treatment is essential. The association of neonatal symptomatic MD with other anomalies is exceptional but is otherwise life threatening despite surgery.

Conclusions Bowel obstruction and pneumoperitoneum are the most frequent clinical manifestations of symptomatic MD in the newborn. Surgery is required for a definitive diagnosis and successful outcome.

From the *S.C. di Clinica Chirurgica Pediatrica, Università degli Studi di Perugia, Ospedale S. Maria della Misericordia Loc. S. Andrea delle Fratte; and †S.S. di Terapia Intensiva Neonatale Ospedale S. Maria della Misericordia Loc. S. Andrea delle Fratte, Perugia, Italy.

Disclosure: The authors declare no conflict of interest.

Reprints: Mirko Bertozzi, MD, S.C. di Clinica Chirurgica Pediatrica, Università degli Studi di Perugia, Ospedale S. Maria della Misericordia, Loc. S. Andrea delle Fratte, 06100 Perugia, Italy (e-mail: mirkobertozzi@hotmail.com).

© 2013 Lippincott Williams & Wilkins, Inc.