Common complications from Meckel's diverticulum include chronic or acute gastrointestinal blood loss (in up to 50%), intestinal obstruction and intussusception. Acute diverticulitis is found in up to 20% of complications arising from Meckel's diverticuli, most commonly in adults, often mimicking acute appendicitis and occasionally leading to perforation and peritonitis.1
In a large case series reporting on the complications from Meckel's diverticuli in children, perforation was uncommon compared to other presentations.2
Acute intraperitoneal haemorrhage from a perforated Meckel's diverticulum is a rare complication,3–5
in particular in children and in the absence of acute diverticulitis. Intraperitoneal haemorrhage associated with Meckel's diverticulitis without perforation also has been reported.6
In the absence of acute inflammatory changes within the diverticulum, the underlying pathology and cause of the perforation in the here presented case was likely of peptic origin. Considering the potentially life-threatening blood loss in cases of young children with rapidly deteriorating clinical picture and signs of peritoneal irritation, surgical exploration should not be delayed.
- Common complications of Meckel's diverticulum include gastrointestinal bleeding, intestinal obstruction, intussusception and acute diverticulitis.
- Perforation of a non-inflamed Meckel's diverticulum is a rare and potentially life-threatening complication.
- Surgical exploration of children presenting with rapidly deteriorating vital signs and peritoneal irritation should not be delayed.