Presumed acquired traction diverticula of the small bowel causing occult bleeding in a child after congenital diaphragmatic hernia repair: a case report

Small bowel diverticula other than Meckel's diverticulum are rare in children, and acquired traction diverticula caused by adhesions have rarely been described.An 11-yearold boy with a history of neonatal congenital diaphragmatic hernia repair presented with refractory iron deficiency anemia and persistently positive fecal occult blood tests.Endoscopy, pertechnetate scintigraphy, computed tomography, and magnetic resonance enterography found no source of bleeding.Capsule endoscopy identified multiple ulcerated jejunoileal diverticula, and the capsule was retained.Laparotomy revealed diffuse adhesions involving nearly the entire small bowel, and histopathological examination confirmed true diverticula in the resected segment.During 2 months of postoperative follow-up, the patient remained free of overt bleeding and abdominal symptoms without iron supplementation.Traction diverticula may be considered as a possible cause of occult small bowel bleeding in children with a history of abdominal surgery.