Perforated Meckel's diverticulum in omphalocele in a newborn: A case report of an uncommon presentation from northern Tanzania

Abstract

Introduction and importance The concurrent existence of Omphalocele and Meckel's diverticulum is not unheard of but is relatively uncommon. A few cases of their coexistence have been reported. Due to the uncommon dual presentation, it is easy to delay or even miss the diagnosis, delaying management. Meckel's diverticulum should be considered if there is a bowel opening on an omphalocele. Case presentation Herein we present a newborn male baby who was referred to us presenting with an omphalocele that was leaking faeces. The baby also had a cleft lip and palate. He was born at term to a 30-year-old mother whose pregnancy was otherwise normal. The fistulated omphalocele was surgically repaired, and the child continued to do well. Clinical discussion Omphalocele and Meckel's diverticulum are both relatively rare congenital malformations that are uncommonly present together. Other congenital malformations can be associated; hence thorough investigations should be carried out when resources are available. The search for associated malformation should not delay the management of the pathology as it can have serious consequences on the health and outcome of the child. Conclusion Fistulation of Meckel's diverticulum on an Omphalocele is rare. Treatment involves surgical resection and repair. Though other co-morbidities should be investigated, investigation for cause and other co-morbidities should not delay surgery.

Perforated Meckel´s diverticulum in large omphalocele: a case report

“…2 Unless it's dilated, MD cannot be diagnosed before birth. 4,5 In our case we described the concurrent existence of Meckel´s diverticulum and a major omphalocele.…”

“…Omphalocele is a midline abdominal wall defect, with a prevalence of 1 in 4,000 to 6,000 live births, [1][2][3][4] and can be associated to others abnormalities, as many as 45% of patients with omphalocele have concomitant congenital heart disease, cleft lip or palate, intestinal, vesical, genital, or diaphragmatic malformations; Beckwith-Wiedeman Syndrome and several chromosomal anomalies. 1,3 It has been associated with gastrointestinal anomalies, like omphalomesenteric duct anomalies, the most frequent association is Meckel´s diverticulum, but the omphalomesenteric fistula is rare as evidenced by the limited number of reports in the literature; 1 as the same in the case of omphalocele with intestinal malrotation have rarely been described.…”

Two Congenital Gastrointestinal Malformations: A Case of Omphalocele and Meckel’s Diverticulum in a Neonate

“…The concurrent incidence of omphalocele and Meckel's diverticulum is not well known but is uncommon, with studies reporting its occurrence in 16% of omphalocele cases [4][5][6].…”

The Co-Existence of Patent Omphalomesenteric Duct and Omphalocele in Patau’s Syndrome in Saudi Arabia: A Case Report

“…There have been case reports, such as those by Lodhia et al and Abdalkarem et al, where patients presented with a perforated Meckle’s diverticulum in an omphalocele without Patau’s syndrome. However, none of them underwent chromosomal analyses [ 19 , 20 ]. In these abovementioned cases, patients were surgically treated via resection of the perforated Meckle’s diverticulum and end-to-end anastomosis, and the omphalocele was repaired [ 19 , 20 ].…”

“…However, none of them underwent chromosomal analyses [ 19 , 20 ]. In these abovementioned cases, patients were surgically treated via resection of the perforated Meckle’s diverticulum and end-to-end anastomosis, and the omphalocele was repaired [ 19 , 20 ]. This suggests that there is a high likelihood of perforation when Meckle’s diverticulum and omphalocele are present simultaneously, despite being rare, making surgery the standard of care.…”