Incidental Double Meckel’s Diverticulum in Wilms Tumor Patient

Meckel's diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract; however, a double MD is rare.We describe two incidentally identified Meckel's diverticula in a 13-year-old girl undergoing treatment for Wilms tumor.The patient presented with abdominal pain and constipation.Imaging showed a large left renal mass and a solitary pulmonary lesion suspicious for metastasis.At exploratory laparotomy, the tumor involved the left kidney and colonic mesentery, with peritoneal implants and enlarged lymph nodes.Two antimesenteric ileal outpouchings consistent with Meckel's diverticula were identified.Because the diverticula were asymptomatic and definitive tumor resection was deferred, they were left in place pending subsequent surgery.Biopsies confirmed Wilms tumor, and chemotherapy was initiated.Five months later, after a favorable response to chemotherapy, the patient underwent left colectomy and radical left nephrectomy with lymph node sampling.The diverticula, approximately 60 cm proximal to the ileocecal valve and 5 cm apart, were resected with a segment of ileum.Histopathology confirmed two true diverticula without heterotopic mucosa.Her postoperative course was uncomplicated.This case adds to the limited pediatric literature on double Meckel's diverticula and illustrates how an incidental finding can be managed in stages during complex oncologic surgery.A previously reported child had a single MD and Wilms tumor; to our knowledge, their coexistence with double diverticula has not been reported.