2018 Volume 54 Issue 2 Pages 253-258
The patient was a 3-day-old male infant. He was born by normal vaginal delivery following an uncomplicated term gestation. Because of bilious vomiting at 3 days of age, he was transferred to our hospital. He underwent exploratory laparotomy for obstruction of the small intestine. Operative findings revealed a perforation at the tip of Meckel’s diverticulum (MD) located 20 cm proximal to the ileocecal valve, and the adhesion between the perforated site and the ileocecal valve caused intestinal obstruction. There was a cystic lesion close to the perforated site, which was not connected to the diverticulum. A portion of the small intestine including MD was resected and ileostomy was constructed. The cystic lesion was also excised. Histopathological analysis revealed that the inflammation and necrosis of MD were localized around the perforated site without any evidence of ectopic gastric mucosa in the resected specimen, and the cystic lesion was composed of necrotic intestinal tissue. From these findings, the cystic lesion was considered to be a dismembered part of the diverticulum formed owing to the torsion of MD. Although some pediatric cases with the torsion of MD have been reported, there has been no report on a case of neonatal perforation of MD.
