Neonatal Ileal Atresia with Impending Perforation of Meckel’s Diverticulum: A Rare Surgical Emergency

Abstract

Background: Neonatal intestinal obstruction is a life-threatening condition often caused by atresias, volvulus, or Hirschsprung’s disease. Among these, ileal atresia is common, but its association with Meckel’s diverticulum and impending perforation is extremely rare and can complicate diagnosis and management.

Case Presentation: We report the case of a 10-day-old male neonate presenting with progressive abdominal distension and bilious vomiting since day 8 of life. Initial stabilization was done with IV fluids and antibiotics. Imaging revealed features of distal intestinal obstruction. Emergency exploratory laparotomy revealed Type IIIb ileal atresia and an adjacent inflamed Meckel’s diverticulum with impending perforation which was adherent to appendix. Surgical management included resection of the atretic ileum, excision of Meckel’s diverticulum, appendectomy, and complete primary ileo-ileal anastomosis. Histopathology confirmed diverticulitis in Meckel’s diverticulum and adherent congested appendix. The postoperative course was uneventful, and the baby was discharged in stable condition and doing well in follow up period.

Conclusion: This case highlights a rare but critical neonatal emergency. Coexisting Meckel’s diverticulum with impending perforation and ileal atresia necessitate a high index of suspicion and urgent surgical intervention to prevent morbidity and mortality