Double Meckel's diverticulum complicated by bleeding in a 3-year-old girl: A case report

ABSTRACT Introduction Double Meckel's diverticulum is an exceptionally rare congenital anomaly: according to the world literature, only 6 cases have been reported in the pediatric population as of 2025. Case presentation A 3-year-old girl was admitted with a diagnosis of “obscure gastrointestinal bleeding.” Her history included an episode of gastrointestinal bleeding 2 months earlier, managed with blood transfusion and fresh frozen plasma at a district hospital. On readmission with rectal bleeding and abdominal pain, her condition was of moderate severity, with hemoglobin 83.7 g/L. Ultrasonography raised suspicion of an ileal diverticulum. Esophagogastroduodenoscopy, colonoscopy, and contrast-enhanced abdominal CT revealed no pathology. Diagnostic laparoscopy revealed two Meckel's diverticula located 10 cm apart, 40 cm from the ileocecal junction. Video-assisted resection of 15 cm of small bowel carrying both diverticula was performed, with an extracorporeal end-to-end ileo-ileal anastomosis. Histological examination confirmed true diverticula with acute inflammation; one diverticulum contained ectopic gastric-type mucosa with a peptic ulcer extending into the submucosa, the probable source of bleeding. The postoperative course was uneventful; oral feeding was resumed on postoperative day 3, and the patient was discharged in satisfactory condition on postoperative day 7. Conclusion Patients who are found to have a Meckel's diverticulum must undergo a thorough inspection of the small bowel because, although rare, a second Meckel's diverticulum can be present.

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