Meckel's diverticulum complicating neonatal umbilical cord clamping.

Amale neonateweighing 3838 g was born at 39weeks of gestation by elective cesarean delivery due to breech presentation. The umbilical cord was clamped by the surgeon approximately 20 cm from the umbilical base and the neonate was transferred to the midwife for final clamping. The cord was clamped again at approximately 3 cm from the umbilical base. The residual umbilical cord was approximately 4 cm in diameter. Immediately after final clamping, meconium appeared in the umbilical stump. This clinical finding led to the presumptive diagnosis of omphalocele. Ultrasound examinations during pregnancy had not demonstrated any sign of abnormality around the umbilicus. The neonate was transferred in a stable condition to the pediatric surgical unit for immediate operative exploration of the umbilical cord. After sedation, a circular incision around the umbilical stump was performed. The bowel was separated and the abnormality was found to be a Meckel's diverticulum. The diverticulum was removed and the ileum closed horizontally. The specimen was sent for pathological evaluation, which confirmed the diagnosis. Meckel's diverticulum, also known as an “ileal appendix,” occurs because of incomplete obliteration of the omphalocele duct. In the vast majority of cases it is asymptomatic but it can be prone to complications, especially in children, because of ectopic epithelial lining and various bands reminiscent of its embryological development. Although the lifetime risk of complications from Meckel's diverticulum varies from 4% to 34%, over 50%–60% of patients who develop symptoms are younger than 2 years of age. Bleeding, intestinal obstruction, volvulus, intussusception, and Meckel's diverticulitis with or without perforation are some of the common complications seen in children [1]. Meckel's diverticulum has no