Perforated Meckel's diverticulum in a preterm newborn. Case report.

Abstract

BACKGROUND: Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract, occurring in approximately 2\% to 3\% of the population. It is estimated that up to 50\% of diverticula contain ectopic tissue, of which 60-85\% is gastric tissue and 5-16\% is pancreatic tissue. Most diverticula are asymptomatic (about 95.2\%) and when they are symptomatic it depends on the type of complication of the diverticulum. CLINICAL CASE: Newborn at 32 weeks gestation, birth weight 1050 g and height 36 cm, with respiratory distress. On admission to the NICU, at 19 hours of age, he was intubated without evidence of abdominal problems. Chest x-ray showed pneumoperi- toneum in the upper abdomen; therefore, exploratory laparotomy was performed and a perforated Meckel's diverticulum was identified 40 cm from the ileocecal valve, which was operated laparoscopically. CONCLUSION: Symptomatic Meckel's diverticulum and the clinical manifestation of its perforation are rare in the neonatal period; therefore, it is difficult to establish a diagnostic suspicion preoperatively. The most appropriate diagnostic and therapeutic approach is similar to other causes of intestinal perforation: laparoscopy.