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VOLUME 21 , ISSUE 11 ( 2017 ) > List of Articles

CASE REPORT

Meckel\'s diverticulitis masquerading as acute pancreatitis: A diagnostic dilemma

C. Danny Darlington, G. Anitha

Keywords : Heterotopic pancreas, ileoileal intussusception, inverted Meckel\'s diverticulum, pancreatitis

Citation Information : Darlington CD, Anitha G. Meckel\'s diverticulitis masquerading as acute pancreatitis: A diagnostic dilemma. Indian J Crit Care Med 2017; 21 (11):789-792.

DOI: 10.4103/ijccm.IJCCM_317_17

License: CC BY-ND 3.0

Published Online: 01-11-2017

Copyright Statement:  Copyright © 2017; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Meckel\'s diverticulum is a remnant of the proximal part of the vitellointestinal duct and is the most common congenital anomaly of the gastrointestinal tract. It may either remain asymptomatic or present with myriad of clinical presentations. Gastrointestinal bleeding is the most common presentation in children whereas it is intestinal obstruction in the case of adults. We report a 9-year-old boy who presented with acute onset of periumbilical pain and nonbilious vomiting. His clinical and laboratory parameters were unremarkable, except for serum amylase levels. He was conservatively managed initially as acute pancreatitis with paralytic ileus. However, the child deteriorated in a course of 2 days with bilious vomiting, abdominal distension, and dehydration. Imaging was suggestive of an ileoileal intussusception, and exploratory laparotomy identified Meckel\'s diverticulum as the lead point for the intussusception. The histopathological examination revealed inflamed heterotopic pancreatic tissue at the apex of the diverticulum thus explaining the elevated amylase levels. This case is reported to highlight the atypical presentation of Meckel\'s diverticulum and the high clinical suspicion warranted in diagnosing such concomitant intussusception.


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