Rationale: Lower gastrointestinal bleeding caused by Meckel diverticulum (MD) with ectopic pancreas is rare and diagnostically challenging in children, particularly due to the frequent absence of gastric mucosa leading to negative Technetium pertechnetate. This study aimed to summarize and analyze the clinical characteristics and management of this condition. Patient Concerns: A retrospective analysis included 3 pediatric patients (2 males, 1 female; aged 2–13 years) treated between July 2013 and March 2023. All presented with hematochezia as the primary symptom. One case was accompanied by abdominal pain, and another presented with sudden syncope. Diagnoses: Technetium pertechnetate was negative in all three patients. The definitive diagnosis of MD was established intraoperatively via diagnostic laparoscopy in all cases. Postoperative histopathological examination confirmed the presence of ectopic pancreatic tissue within the resected diverticula. Interventions: All patients underwent diagnostic laparoscopic exploration, which confirmed the MD. A laparoscopic-assisted diverticulectomy was subsequently performed. Outcomes: The surgical intervention completely resolved hematochezia in all children. Postoperative recovery was uneventful, with patients resuming oral intake on postoperative day 3 and being discharged 4 to 5 days after surgery. Follow-up at 1, 3, and 6 months showed no recurrence of symptoms, and abdominal ultrasounds revealed no abnormalities. Lessons: MD with ectopic pancreas in children lacks specific clinical manifestations. Preoperative diagnosis is challenging, as the absence of gastric mucosa often results in negative Technetium pertechnetate. Laparoscopic exploration serves as a valuable minimally invasive approach that provides both definitive diagnosis and therapeutic management in cases with high clinical suspicion.
Lai et al. (Fri,) studied this question.