Inverted Meckel’s Diverticulum Simulating Pedunculated Polyp as a Lead Point for Ileoileal Intussusception in a Child

Abstract

A 2-year-old girl presented with one day history of abdominal distension, bilious vomiting and not passing stool. There was no preceding history of significant illness. The patient was vitally stable. Abdomen was distended with tenderness on right side. Digital rectal examination revealed an empty rectum. Abdominal radiograph showed air fluid levels. Ultrasound of abdomen gave an impression of intussusception. Laboratory investigations were within normal limits. Patient was managed with intravenous fluids, prophylactic antibiotics, nasogastric decompression, and analgesics. Exploratory laparotomy was performed within 3 hours of presentation that revealed an ileoileal intussusception which was manually reduced. A polyp like pedunculated growth was palpable at about 30 cm proximal to ileocecal valve. An enterotomy was performed for polypectomy; however, the pedunculated growth had a pale tissue at the tip giving a suspicion of heterotopic tissue.