Uncommon presentation of perforated Meckel’s diverticulum in preterm newborn

A male neonate with gestational age of 30 weeks, weighting 940 g at birth, with respiratory failure right after birth, and radiological signs compatible with hyaline membrane disease. At his tenth day of life, the patient presented vomiting and abdominal distention, presenting with radiological signs of pneumoperitoneum (Figure 1). Initially, the neonate was submitted to peritoneal drainage, due to the lack of surgical conditions, and at the 19th day, after gaining weight and present with hemodynamically stable conditions, was submitted to exploratory laparotomy. During the surgery, a Meckel’s diverticulum (MD) was found, with jejunal perforation, hepatic blockage and obstruction distal to the blockage due to the development of adherence. Resection of about 6 cm of the jejunal loop including the perforated area was performed, with later termino-terminal anastomosis. The anatomopathological result was subacute diverticulitis with ulcer and severe peridiverticulitis. The neonate presented a favorable evolution and was discharged at his 82nd day of life. Meckel’s diverticulum represents the most common congenital malformation of the digestive tube, and is asymptomatic in most cases. Symptomatic cases of MD are rarely found, affecting less than 20% of all pediatric cases. Bowel obstruction http://dx.doi.org/10.1590/0100-3984.2014.0064 Ronaldo Garcia Rondina, Ricardo Andrade Fernandes de Mello, Gabriel Antônio de Oliveira, Laís Bastos Pessanha, Luiz Felipe Alves Guerra, Diego Lima Nava Martins