An uncommon variant of Meckel's diverticulum.

A 7-month-old boy was admitted to our clinic with apparently painless rectal bleeding. No abnormality was detected on physical examination. Erythrocyte and technetium-99m scintigraphy gave negative results. The first episode lasted about 18 hours. A second episode occurred a month later. This time both scintigraphic studies were positive for bleeding Meckel’s diverticulum. Laparotomy was performed electively. During exploration a diverticulum was detected about 40 cm from the ileocecal valve, and multiple mesenteric lymphadenopathies were present. The diverticulum was a Meckel’s diverticulum except that it was located on the mesenteric border of the ileum; the antimesenteric border of ileum was normal (Fig. 1). Since it was located at the base of the mesentery, resection and anastomosis was preferred instead of a wedge resection. Pathological examination revealed a free antimesenteric border of ileum and a Meckel’s diverticulum, the base of which was at the mesenterolateral junction of the ileum. It had a base of about 2 cm and a direct wide connection with the adjacent ileum. On microscopic examination there was congestion and fibrin accumulation. Heterotopic gastric mucosa was detected but no Helicobacter pylori. Postoperative recovery was uncomplicated.