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An 8-year-old boy with a history of recurrent abdominal pain presented with a 12 h history of severe periumbilical pain, nausea and vomiting. On examination, he was found to have a tender, erythematous, paraumbilical mass. At operative exploration, an abscess cavity was identified and followed to reveal a gangrenous Meckel's diverticulum, perforated at its tip to create the abscess. Around this Meckel's diverticulum, the small bowel had torted to produce a significant small bowel volvulus on a shortened mesentery. The caecum and ascending colon were found to be in the left upper quadrant and an intraoperative diagnosis of malrotation was made. Following resection of the Meckel's diverticulum and surgical correction of the malrotation, the child made an excellent recovery. His abdominal pain has not recurred in 6 months of follow-up since the operation.

Original publication

DOI

10.1136/bcr-2015-212377

Type

Journal

BMJ Case Rep

Publication Date

28/10/2015

Volume

2015

Keywords

Abdominal Pain, Child, Diagnosis, Differential, Humans, Intestinal Perforation, Intestinal Volvulus, Male, Meckel Diverticulum, Recurrence, Treatment Outcome