Small bowel obstruction due to Meckel's diverticulitis in a 5-year-old child: a case report

Meckel’s diverticulum is the most common congenital anomaly of the gastrointestinal tract, yet small bowel obstruction caused by its inflammation remains exceptionally rare, especially in children. A previously healthy 5-year-old girl presented at a regional hospital with fever and abdominal pain for five days, followed by absence of stool and gas passage for 24 hours. Laboratory tests showed leukocytosis (22,000 cells/mm 3 ) and elevated C-reactive protein (200 mg/L). Abdominal ultrasound revealed signs of small bowel obstruction, free intraperitoneal fluid but no visible appendix. Computed tomography demonstrated small bowel obstruction with possible decreased enhancement in a short segment of small bowel located in the subhepatic region, which prompted a transfer of the patient to our center. The patient, who showed stable vital signs and no evidence of peritonitis, underwent an MRI to further clarify the diagnosis. This exam suggested an internal hernia. Exploratory laparoscopy converted to laparotomy revealed a necrotic Meckel’s diverticulum, whose thin pedicle was strangulating the small bowel. A wedge resection of the diverticulum was performed. The postoperative course was uneventful, and the patient was discharged on day four. At two-week follow-up, she was asymptomatic. Meckel's diverticulitis must be included in the differential diagnosis of children who develop a small bowel obstruction.