Atypical presentation of Meckel’s diverticulum in late childhood with dual ectopic gastric and pancreatic mucosa: a case report

Meckel's diverticulum (MD) is a common congenital anomaly, usually symptomatic in early childhood. The presence of multiple heterotopic tissues within a single diverticulum is rare and poses significant diagnostic challenges. In this report, a 12-year-old male presented with a month-long history of painless lower gastrointestinal (GI) bleeding (melena and hematochezia). While endoscopy was normal, ^99mTc scintigraphy revealed MD in the right pelvic region. Laparoscopic diverticulectomy was performed, and histopathology confirmed MD containing dual ectopic gastric and pancreatic tissues. Symptoms resolved completely postoperatively. MD occurs in 2% of the population; while typically associated with gastric mucosa, the coexistence of pancreatic tissue is uncommon and can lead to atypical presentations in older children. This case underscores the value of the Meckel's scan and clinical suspicion beyond early childhood. MD should be considered in adolescents with unexplained GI bleeding, as rare histopathological findings and prompt surgery are key to successful outcomes.