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

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.
Source: Indian Journal of Critical Care Medicine - Category: Intensive Care Authors: Source Type: research

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