Meckel’s diverticulum and fibrous residual omphaloenteric duct with ectopic endocrine pancre-atic tissue as a cause of ileus

Czech version

Authors: Jiří Slavíček ¹; Jakub Fichtl ¹; Ondřej Daum ²; Jiří Moláček ¹
Authors‘ workplace: Chirurgická klinika, Lékařská fakulta, Univerzita Karlova a Fakultní nemocnice Plzeň ¹; Šiklův ústav patologie, Lékařská fakulta, Univerzita Karlova a Fakultní nemocnice Plzeň ²
Published in: Čes-slov Pediat 2026; 81 (5): 284-287.
Category: Case Report
doi: https://doi.org/10.55095/CSPediatrie2026/037

Overview

Meckel’s diverticulum is the most common congenital anomaly of the gastrointestinal tract. The incidence ranges between 1–3 %. Only approximately 4 % of cases manifest clinically, and only rarely as an acute abdomen requiring surgical intervention. A symptomatic diverticulum occurs more frequently in male population and most commonly presents as gastrointestinal bleeding. Up to 50 % of Meckel’s diverticulum contain heterotopic mucosa originating in the pancreas or stomach.

In this case report we present a 5-year-old boy with a history of abdominal pain lasting several hours and a diagnosis of small bowel ileus. An acute laparotomy was performed with the finding a Meckel’s diverticulum, which continued as a fibrous remnant to the umbilicus and caused strangulation of a small bowel loop. The histological finding was surprising, where in addition to heterotopia of oxyntic gastric mucosa, endocrine pancreatic tissue was identified in the fibrous remnant outside the diverticulum itself.

Keywords:

strangulation – acute abdomen – ileus – Meckel’s diverticulum – congenital gastrointestinal tract anomaly – endocrine pancreatic tissue – omphalomesenteric duct

Sources

1. Krška Z, Ulrych J, et al. Náhlé příhody břišní: aktuální pohled na klasifikaci, diagnostiku a léčbu. 2. díl. Albertova sbírka. 1. vyd. Praha: We Make Media 2022.

2. Šebek J, Třeška V, Vodička J, et al. Meckelův divertikl jako příčina náhlé příhody břišní. Gastroent Hepatol 2018; 72(6): 518–521.

3. Zeman L, Kučera A, Vyhnálek M, Fryč R. Meckelův divertikl –⁠ méně obvyklé projevy. Pediatr praxi 2008; 9(4): 257–259.

4. Rhodes E, Stone T, Spruill L, Hardie AD. A case report of inverted Meckel’s diverticulum. Radiol Case Rep 2021; 16(5): 1118–1122.

5. Kabir SA, Raza SA, Kabir SI. Malignant neoplasms of Meckel’s diverticulum; an evidence based review. Ann Med Surg (Lond) 2019; 43 : 75–81.

6. Zeman M, Krška Z, et al. Speciální chirurgie. 3., dopl. a přeprac. vyd. Praha: Galén 2014.

7. Wlaź J, Mądro A, Kaźmierak W, et al. Pancreatic and gastric heterotopy in the gastrointestinal tract. Postepy Hig Med Dosw (Online) 2014; 68 : 1069–75.

8. Sovadinová D, Limprechtová T, Borůvková K, et al. Meckelův divertikl jako příčina krvácení do gastrointestinálního traktu u adolescentního pacienta. Rozhl Chir 2024; 103 : 138–142.

9. Ludwig K, De Bartolo D, Salerno A, et al. Congenital anomalies of the tubular gastrointestinal tract. Pathologica 2022; 114(1): 40–54.

10. Hansen CC, Søreide K. Systematic review of epidemiology, presentation, and management of Meckel’s diverticulum in the 21st century. Medicine (Baltimore) 2018; 97(35): e12154.

11. Farrell MB, Zimmerman J. Meckel’s diverticulum imaging. J Nucl Med Technol 2020; 48(3): 210–213.

12. Akbulut S, Yagmur Y. Giant Meckel’s diverticulum: an exceptional cause of intestinal obstruction. World J Gastrointest Surg 2014; 6(3): 47–50.