Intestinal Obstruction in Toddler - Meckel\u2019s Band Case<\/title>\r\n \r\n \r\n <link href=\"https:\/\/cdn.jsdelivr.net\/npm\/bootstrap@5.3.3\/dist\/css\/bootstrap.min.css\" rel=\"stylesheet\">\r\n \r\n \r\n <link rel=\"stylesheet\" href=\"https:\/\/cdnjs.cloudflare.com\/ajax\/libs\/font-awesome\/6.5.0\/css\/all.min.css\">\r\n \r\n \r\n <link href=\"https:\/\/unpkg.com\/aos@2.3.1\/dist\/aos.css\" rel=\"stylesheet\">\r\n \r\n <style>\r\n body { \r\n background: linear-gradient(-45deg, #e0f7fa, #b2ebf2, #80deea, #4dd0e1);\r\n background-size: 400% 400%;\r\n animation: gradientBG 15s ease infinite;\r\n font-family: 'Segoe UI', Tahoma, Geneva, Verdana, sans-serif; \r\n color: #2c3e50; \r\n min-height: 100vh;\r\n }\r\n @keyframes gradientBG {\r\n 0% { background-position: 0% 50%; }\r\n 50% { background-position: 100% 50%; }\r\n 100% { background-position: 0% 50%; }\r\n }\r\n .header { \r\n background: linear-gradient(135deg, #007bff, #6610f2, #e91e63); \r\n color: white; \r\n padding: 100px 20px; \r\n text-align: center; \r\n border-radius: 0 0 60px 60px; \r\n box-shadow: 0 20px 40px rgba(0,0,0,0.3); \r\n }\r\n .header h1 {\r\n animation: bounceIn 1.8s ease;\r\n }\r\n @keyframes bounceIn {\r\n 0% { transform: scale(0.6); opacity: 0; }\r\n 60% { transform: scale(1.15); opacity: 1; }\r\n 100% { transform: scale(1); }\r\n }\r\n .section-card, .awareness-box { \r\n border-radius: 25px; \r\n box-shadow: 0 15px 35px rgba(0,0,0,0.2); \r\n transition: all 0.5s ease;\r\n background: white;\r\n }\r\n .section-card:hover, .awareness-box:hover {\r\n transform: translateY(-12px);\r\n box-shadow: 0 25px 50px rgba(0,123,255,0.3);\r\n }\r\n .awareness-box { \r\n background: linear-gradient(135deg, #fff176, #ffe082); \r\n border: 5px solid #ffca28; \r\n padding: 35px; \r\n animation: heartbeat 2.5s infinite;\r\n }\r\n @keyframes heartbeat {\r\n 0%, 100% { transform: scale(1); }\r\n 50% { transform: scale(1.04); }\r\n }\r\n .img-container {\r\n position: relative;\r\n overflow: hidden;\r\n border-radius: 20px;\r\n box-shadow: 0 10px 25px rgba(0,0,0,0.2);\r\n }\r\n .img-container img {\r\n transition: all 0.7s ease;\r\n width: 100%;\r\n }\r\n .img-container:hover img {\r\n transform: scale(1.12) rotate(4deg);\r\n }\r\n .emoji { font-size: 2.5rem; margin-right: 15px; }\r\n .accordion-button:not(.collapsed) {\r\n background: linear-gradient(to right, #0d6efd, #6610f2);\r\n color: white;\r\n }\r\n <\/style>\r\n<\/head>\r\n<body>\r\n\r\n <div class=\"header\" data-aos=\"zoom-in-down\" data-aos-duration=\"1500\">\r\n <h1 class=\"display-4 fw-bold\"><i class=\"fas fa-heartbeat me-3\"><\/i> Intestinal Obstruction in a Toddler Due to a Meckel\u2019s Band<\/h1>\r\n <p class=\"lead fs-4\">A Case of Diagnostic Challenge and Successful Surgical Management<\/p>\r\n <\/div>\r\n\r\n <div class=\"container my-5\">\r\n\r\n \r\n <div class=\"card section-card mb-5\" data-aos=\"fade-up\">\r\n <div class=\"card-body p-5\">\r\n <h2 class=\"text-primary mb-4\"><i class=\"fas fa-file-medical\"><\/i> Abstract<\/h2>\r\n <p><strong>Introduction:<\/strong> Intestinal obstruction in toddlers presents a diagnostic dilemma, with common causes being intussusception, hernias and congenital anomalies. Meckel\u2019s diverticulum, though a common congenital anomaly, typically presents with painless rectal bleeding. Its complications, like a persistent vitellointestinal band (Meckel\u2019s band), causing acute mechanical obstruction are a rarer clinical entity.<\/p>\r\n <p><strong>Case Presentation:<\/strong> We report a case of a 16-month old female who presented with a 7-days history of progressive abdominal distension, 4 days of bilious vomiting and 4 days of absolute constipation. Digital rectal examination revealed finger stained with blood, initially raising suspicion for intussusception.<\/p>\r\n <p><strong>Management and outcome:<\/strong> Emergency laparotomy revealed a congenital band extending from a Meckel\u2019s diverticulum to the umbilicus, causing a closed loop obstruction of the distal ileum. A wedge resection of the diverticulum with ileo-transverse anastomosis was performed. The postoperative course was uneventful. The patient was managed with nothing per oral and intravenous fluid for 5 days, with a drain in situ. She was discharged on the 6th postoperative day in good health, with no wound infection.<\/p>\r\n <p><strong>Conclusion:<\/strong> This case underscores that while intussusception is a prime consideration in a toddler with intestinal obstruction and rectal bleeding, congenital bands from a Meckel\u2019s diverticulum must remain a vital differential diagnosis. A high index of suspicion and timely surgical intervention are crucial for a favorable outcome.<\/p>\r\n <\/div>\r\n <\/div>\r\n\r\n \r\n <div class=\"row g-4 mb-5\">\r\n <div class=\"col-md-4\" data-aos=\"flip-left\">\r\n <div class=\"img-container\">\r\n <img decoding=\"async\" src=\"https:\/\/upload.wikimedia.org\/wikipedia\/commons\/f\/fe\/Diverticule_de_Meckel.jpg\" alt=\"Meckel's Diverticulum\">\r\n <\/div>\r\n <\/div>\r\n <div class=\"col-md-4\" data-aos=\"flip-up\">\r\n <div class=\"img-container\">\r\n <img decoding=\"async\" src=\"https:\/\/image.slidesharecdn.com\/meckelsdiverticulum-170505174554\/75\/Meckel-s-diverticulum-11-2048.jpg\" alt=\"Meckel's Band Illustration\">\r\n <\/div>\r\n <\/div>\r\n <div class=\"col-md-4\" data-aos=\"flip-right\">\r\n <div class=\"img-container\">\r\n <img decoding=\"async\" src=\"https:\/\/thumbs.dreamstime.com\/b\/cute-girl-stomachache-have-friend-soothe-66480222.jpg\" alt=\"Child with Stomach Pain Cartoon\">\r\n <\/div>\r\n <\/div>\r\n <\/div>\r\n\r\n \r\n <div class=\"awareness-box mb-5\" data-aos=\"zoom-in\">\r\n <h3 class=\"fw-bold mb-4\"><i class=\"fas fa-baby\"><\/i> \u09b6\u09bf\u09b6\u09c1\u09a4\u09c7 \u0985\u09a8\u09cd\u09a4\u09cd\u09b0\u09c7\u09b0 \u09ac\u09be\u09a7\u09be: \u09ae\u09c7\u0995\u09c7\u09b2\u09c7\u09b0 \u09ac\u09cd\u09af\u09be\u09a8\u09cd\u09a1\u09c7\u09b0 \u0995\u09be\u09b0\u09a3\u09c7 \u098f\u0995 \u0998\u099f\u09a8\u09be<\/h3>\r\n <p><strong>\ud83d\udc76 \u0998\u099f\u09a8\u09be\u09b0 \u09b8\u09be\u09b0\u09b8\u0982\u0995\u09cd\u09b7\u09c7\u09aa:<\/strong> \u098f\u0995\u099c\u09a8 \u09e7\u09ec \u09ae\u09be\u09b8 \u09ac\u09af\u09bc\u09b8\u09c0 \u09ae\u09c7\u09af\u09bc\u09c7\u09b6\u09bf\u09b6\u09c1 \u09b9\u09a0\u09be\u09ce \u0995\u09b0\u09c7 \u09a4\u09c0\u09ac\u09cd\u09b0 \u09aa\u09c7\u099f \u09ab\u09be\u0981\u09aa\u09be, \u09ac\u09ae\u09bf (\u09b8\u09ac\u09c1\u099c\u09be\u09ad\/\u09aa\u09bf\u09a4\u09cd\u09a4 \u09ae\u09bf\u09b6\u09cd\u09b0\u09bf\u09a4), \u098f\u09ac\u0982 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<p><strong>\ud83d\udd0e \u0985\u09aa\u09be\u09b0\u09c7\u09b6\u09a8\u09c7 \u0995\u09c0 \u09aa\u09be\u0993\u09af\u09bc\u09be \u0997\u09c7\u09b2:<\/strong> \u09b6\u09bf\u09b6\u09c1\u09b0 \u09aa\u09c7\u099f\u09c7 \u0985\u09b8\u09cd\u09a4\u09cd\u09b0\u09cb\u09aa\u099a\u09be\u09b0 \u0995\u09b0\u09b2\u09c7 \u09a6\u09c7\u0996\u09be \u09af\u09be\u09af\u09bc \u098f\u0995\u099f\u09bf \u099c\u09a8\u09cd\u09ae\u0997\u09a4 \u09ab\u09be\u0987\u09ac\u09be\u09b0 \u09ac\u09cd\u09af\u09be\u09a8\u09cd\u09a1 (\u09ae\u09c7\u0995\u09c7\u09b2\u09c7\u09b0 \u09ac\u09cd\u09af\u09be\u09a8\u09cd\u09a1) \u09ae\u09c7\u0995\u09c7\u09b2\u09c7\u09b0 \u09a1\u09be\u0987\u09ad\u09be\u09b0\u09cd\u099f\u09bf\u0995\u09c1\u09b2\u09be\u09ae \u09a5\u09c7\u0995\u09c7 \u09a8\u09be\u09ad\u09bf\u09b0 \u09a6\u09bf\u0995\u09c7 \u0997\u09bf\u09af\u09bc\u09c7\u099b\u09c7\u0964 \u098f\u0987 \u09ac\u09cd\u09af\u09be\u09a8\u09cd\u09a1\u09c7\u09b0 \u09a8\u09bf\u099a\u09c7 \u0985\u09a8\u09cd\u09a4\u09cd\u09b0 \u0986\u099f\u0995\u09c7 \u0997\u09bf\u09af\u09bc\u09c7 \u09b8\u09ae\u09cd\u09aa\u09c2\u09b0\u09cd\u09a3 \u09ac\u09cd\u09b2\u0995 \u09b9\u09af\u09bc\u09c7 \u09af\u09be\u09af\u09bc \u098f\u09ac\u0982 \u0995\u09bf\u099b\u09c1 \u0985\u0982\u09b6\u09c7 \u0985\u09a8\u09cd\u09a4\u09cd\u09b0 \u09a8\u09b7\u09cd\u099f \u09b9\u09af\u09bc\u09c7 \u0997\u09c7\u099b\u09c7\u0964<\/p>\r\n <p><strong>\u2695\ufe0f \u099a\u09bf\u0995\u09bf\u09ce\u09b8\u09be:<\/strong> \u09ac\u09cd\u09af\u09be\u09a8\u09cd\u09a1 \u0995\u09c7\u099f\u09c7 \u09ab\u09c7\u09b2\u09be \u09b9\u09af\u09bc\u0964 \u09ae\u09c7\u0995\u09c7\u09b2\u09c7\u09b0 \u09a1\u09be\u0987\u09ad\u09be\u09b0\u09cd\u099f\u09bf\u0995\u09c1\u09b2\u09be\u09ae \u0985\u0982\u09b6 \u0995\u09c7\u099f\u09c7 \u09ac\u09be\u09a6 \u09a6\u09c7\u0993\u09af\u09bc\u09be \u09b9\u09af\u09bc\u0964 \u09a8\u09b7\u09cd\u099f \u09b9\u0993\u09af\u09bc\u09be \u0985\u09a8\u09cd\u09a4\u09cd\u09b0\u09c7\u09b0 \u0985\u0982\u09b6 \u0995\u09c7\u099f\u09c7 \u09ab\u09c7\u09b2\u09c7 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\u09a8\u09af\u09bc, \u099c\u09a8\u09cd\u09ae\u0997\u09a4 \u09ac\u09cd\u09af\u09be\u09a8\u09cd\u09a1 \u09ac\u09be \u09ae\u09c7\u0995\u09c7\u09b2\u09c7\u09b0 \u09a1\u09be\u0987\u09ad\u09be\u09b0\u09cd\u099f\u09bf\u0995\u09c1\u09b2\u09be\u09ae\u0993 \u0995\u09be\u09b0\u09a3 \u09b9\u09a4\u09c7 \u09aa\u09be\u09b0\u09c7\u0964 \u09b8\u09ae\u09af\u09bc\u09ae\u09a4\u09cb \u0985\u09b8\u09cd\u09a4\u09cd\u09b0\u09cb\u09aa\u099a\u09be\u09b0 \u0995\u09b0\u09b2\u09c7 \u099c\u09c0\u09ac\u09a8 \u09ac\u09be\u0981\u099a\u09be\u09a8\u09cb \u09b8\u09ae\u09cd\u09ad\u09ac\u0964<\/p>\r\n <\/div>\r\n\r\n \r\n <div class=\"row g-4 mb-5\">\r\n <div class=\"col-md-6\" data-aos=\"fade-up\">\r\n <div class=\"img-container\">\r\n <img decoding=\"async\" src=\"https:\/\/thumbs.dreamstime.com\/b\/children-get-sick-isolated-white-background-child-has-high-temperature-boy-hit-hammer-finger-toothache-boy-s-stomach-ache-83589714.jpg\" alt=\"Child Stomach Ache Cartoon\">\r\n <\/div>\r\n <\/div>\r\n <div class=\"col-md-6\" data-aos=\"fade-up\" data-aos-delay=\"200\">\r\n <div class=\"img-container\">\r\n <img decoding=\"async\" src=\"https:\/\/www.shutterstock.com\/shutterstock\/photos\/2720740361\/display_1500\/stock-vector-little-girl-cries-and-holds-her-stomach-in-pain-representing-common-childhood-illnesses-like-food-2720740361.jpg\" alt=\"Girl Holding Stomach in Pain\">\r\n <\/div>\r\n <\/div>\r\n <\/div>\r\n\r\n \r\n <div class=\"alert alert-warning awareness-box mb-5\" role=\"alert\" data-aos=\"pulse\">\r\n <h4 class=\"alert-heading\"><i class=\"fas fa-exclamation-triangle me-2\"><\/i> \u099c\u09a8\u09b8\u099a\u09c7\u09a4\u09a8\u09a4\u09be \u09ac\u09be\u09b0\u09cd\u09a4\u09be \ud83e\ude7a<\/h4>\r\n <p>\u099b\u09cb\u099f \u09b6\u09bf\u09b6\u09c1\u09a6\u09c7\u09b0 \u09b9\u09a0\u09be\u09ce \u09aa\u09c7\u099f \u09ab\u09be\u0981\u09aa\u09be, \u09ac\u09ae\u09bf (\u09ac\u09bf\u09b6\u09c7\u09b7 \u0995\u09b0\u09c7 \u09b8\u09ac\u09c1\u099c\u09be\u09ad \u09ac\u09be \u09aa\u09bf\u09a4\u09cd\u09a4 \u09ae\u09bf\u09b6\u09cd\u09b0\u09bf\u09a4), \u098f\u09ac\u0982 \u0995\u09af\u09bc\u09c7\u0995\u09a6\u09bf\u09a8 \u09a7\u09b0\u09c7 \u09ae\u09b2 \u09a8\u09be \u09b9\u0993\u09af\u09bc\u09be \u0985\u09a8\u09cd\u09a4\u09cd\u09b0\u09c7 \u09ac\u09be\u09a7\u09be\u09b0 \u09b2\u0995\u09cd\u09b7\u09a3 \u09b9\u09a4\u09c7 \u09aa\u09be\u09b0\u09c7\u0964 \u0985\u09a8\u09c7\u0995 \u09b8\u09ae\u09af\u09bc \u09a1\u09be\u0995\u09cd\u09a4\u09be\u09b0\u09b0\u09be \u09aa\u09cd\u09b0\u09a5\u09ae\u09c7 \u09ae\u09a8\u09c7 \u0995\u09b0\u09c7\u09a8 \u098f\u099f\u09bf \u0987\u09a8\u099f\u09c1\u09b8\u09be\u09b8\u09c7\u09aa\u09b6\u09a8, \u0995\u09bf\u09a8\u09cd\u09a4\u09c1 \u0995\u09bf\u099b\u09c1 \u0995\u09cd\u09b7\u09c7\u09a4\u09cd\u09b0\u09c7 \u099c\u09a8\u09cd\u09ae\u0997\u09a4 \u0985\u09b8\u09cd\u09ac\u09be\u09ad\u09be\u09ac\u09bf\u0995\u09a4\u09be \u09af\u09c7\u09ae\u09a8 \u09ae\u09c7\u0995\u09c7\u09b2\u09c7\u09b0 \u09ac\u09cd\u09af\u09be\u09a8\u09cd\u09a1 \u0985\u09a8\u09cd\u09a4\u09cd\u09b0\u0995\u09c7 \u0986\u099f\u0995\u09c7 \u09a6\u09bf\u09af\u09bc\u09c7 \u09ae\u09be\u09b0\u09be\u09a4\u09cd\u09ae\u0995 \u09ac\u09be\u09a7\u09be \u09b8\u09c3\u09b7\u09cd\u099f\u09bf \u0995\u09b0\u09a4\u09c7 \u09aa\u09be\u09b0\u09c7\u0964 \u098f\u0987 \u0985\u09ac\u09b8\u09cd\u09a5\u09be\u09af\u09bc \u0985\u09a8\u09cd\u09a4\u09cd\u09b0 \u09a6\u09cd\u09b0\u09c1\u09a4 \u09a8\u09b7\u09cd\u099f \u09b9\u09af\u09bc\u09c7 \u09af\u09c7\u09a4\u09c7 \u09aa\u09be\u09b0\u09c7\u0964<\/p>\r\n <p><strong>\u26a0\ufe0f \u0995\u09bf \u0995\u09b0\u09a4\u09c7 \u09b9\u09ac\u09c7:<\/strong> \u09b6\u09bf\u09b6\u09c1\u09b0 \u09aa\u09c7\u099f\u09c7 \u09b9\u09a0\u09be\u09ce \u09ab\u09be\u0981\u09aa\u09be, \u09ac\u09ae\u09bf, \u09ae\u09b2 \u09a8\u09be \u09b9\u0993\u09af\u09bc\u09be \u09ac\u09be \u09b0\u0995\u09cd\u09a4 \u09ae\u09bf\u09b6\u09cd\u09b0\u09bf\u09a4 \u09b6\u09cd\u09b2\u09c7\u09b7\u09cd\u09ae\u09be \u09a6\u09c7\u0996\u09be \u09a6\u09bf\u09b2\u09c7 \u09a6\u09c7\u09b0\u09bf \u09a8\u09be \u0995\u09b0\u09c7 \u09a6\u09cd\u09b0\u09c1\u09a4 \u09b9\u09be\u09b8\u09aa\u09be\u09a4\u09be\u09b2\u09c7 \u09a8\u09bf\u09af\u09bc\u09c7 \u09af\u09be\u09a8\u0964 \u09b8\u09ae\u09af\u09bc\u09ae\u09a4\u09cb \u0985\u09b8\u09cd\u09a4\u09cd\u09b0\u09cb\u09aa\u099a\u09be\u09b0 \u0995\u09b0\u09b2\u09c7 \u09b6\u09bf\u09b6\u09c1\u09b0 \u099c\u09c0\u09ac\u09a8 \u09ac\u09be\u0981\u099a\u09be\u09a8\u09cb \u09b8\u09ae\u09cd\u09ad\u09ac\u0964<\/p>\r\n <p><strong>\ud83d\udca1 \u09ae\u09c2\u09b2 \u09ac\u09be\u09b0\u09cd\u09a4\u09be:<\/strong> \u09b6\u09bf\u09b6\u09c1\u09b0 \u09aa\u09c7\u099f\u09c7\u09b0 \u09b8\u09ae\u09b8\u09cd\u09af\u09be\u0995\u09c7 \u09b9\u09be\u09b2\u0995\u09be\u09ad\u09be\u09ac\u09c7 \u09a8\u09c7\u09ac\u09c7\u09a8 \u09a8\u09be\u0964 \u09a6\u09cd\u09b0\u09c1\u09a4 \u099a\u09bf\u0995\u09bf\u09ce\u09b8\u09be \u09a8\u09bf\u09b2\u09c7 \u099c\u099f\u09bf\u09b2\u09a4\u09be \u098f\u09a1\u09bc\u09be\u09a8\u09cb \u09af\u09be\u09af\u09bc\u0964<\/p>\r\n <\/div>\r\n\r\n \r\n <div class=\"accordion shadow\" id=\"caseAccordion\">\r\n <div class=\"accordion-item\" data-aos=\"fade-up\">\r\n <h2 class=\"accordion-header\">\r\n <button class=\"accordion-button\" type=\"button\" data-bs-toggle=\"collapse\" data-bs-target=\"#intro\">\r\n 1. Introduction\r\n <\/button>\r\n <\/h2>\r\n <div id=\"intro\" class=\"accordion-collapse collapse show\">\r\n <div class=\"accordion-body\">\r\n Acute intestinal obstruction in infants and toddlers is a surgical emergency. The leading causes include intussusception, incarcerated inguinal hernia, and intestinal atresia like duodenal web. Meckel\u2019s diverticulum, a remnant of the omphalomesenteric duct, is the most prevalent congenital gastrointestinal anomaly, found in approximately 2 %of the population. while often asymptomatic, its complications can include hemorrhage, diverticulitis and intestinal obstruction. Obstruction typically occurs due to intussusception, volvulus around a fibrous band connecting the diverticulum to the umbilicus or incarceration with a hernia (Littre\u2019s hernia). We present a case of a 16 month old girl where a Meckel\u2019s band caused a complete small bowel obstruction, mimicking the classic presentation of intussusception.\r\n <\/div>\r\n <\/div>\r\n <\/div>\r\n\r\n <div class=\"accordion-item\" data-aos=\"fade-up\" data-aos-delay=\"100\">\r\n <h2 class=\"accordion-header\">\r\n <button class=\"accordion-button collapsed\" type=\"button\" data-bs-toggle=\"collapse\" data-bs-target=\"#case\">\r\n 2. Case Presentation\r\n <\/button>\r\n <\/h2>\r\n <div id=\"case\" class=\"accordion-collapse collapse\">\r\n <div class=\"accordion-body\">\r\n <strong>2.1. Patient information:<\/strong> A 16-month old previously healthy female infant, wt-10 kg presented to the emergency department.<br><br>\r\n <strong>2.2. Clinical History:<\/strong> The parents reported a 7 days history of increasing abdominal distension, associated with irritability and poor feeding and intermittent crying. This progressed to bilious vomiting for the last 4 days. There was no passage of stool for 4 days only few blood stained mucous like material came out. There was no history of fever, trauma, diarrhoea or similar episodes in the past.<br><br>\r\n <strong>2.3. Clinical findings:<\/strong> On examination: The child was irritable, tachycardiac and mildly dehydrated. The abdomen was markedly distended later, tense and tender on palpation, with no palpable mass. Bowel sounds were hyperactive initially but become sluggish later. Digital Rectal Examination: Revealed an empty rectal ampulla with the examining finger stained with mucous mixed blood.<br><br>\r\n <strong>2.4. Diagnostic Assessment:<\/strong> Based on the clinical triad of abdominal distension, bilious vomiting and constipation, a diagnosis of acute intestinal obstruction was made. The finding of blood on DRE, along with the age of the patient, made intussusception the leading preoperative diagnosis. An abdominal ultrasound was performed which shows no target sign but revealed dilated small bowel loops with fluid level. Given the clinical picture of complete obstruction, the decision was made for an emergency exploratory laparotomy.<br><br>\r\n <strong>2.5. Therapeutic Intervention:<\/strong> A Transverse supraumbilical (Rt) incision was given. Intraoperative findings revealed a grossly dilated proximal small bowel and collapsed distal bowel. A fibrous band (Meckel\u2019s band) was identified, extending from the tip of a Meckel\u2019s diverticulum to the mesentery. A loop of distal ileum was entrapped under this band, causing a tight, closed loop obstruction. There was no evidence of intussusception but bowel was necrosed at the part where fibrous band compressed the gut which is about 5 cm proximal to the ileo-cecal valve. The band was lysed. A wedge resection of the Meckel\u2019s diverticulum at its base on the antimesenteric border was performed, followed by resection of the gangrenous part upto ascending colon and end to end anastomosis was done. A drain was placed in the pelvis.\r\n <\/div>\r\n <\/div>\r\n <\/div>\r\n\r\n <div class=\"accordion-item\" data-aos=\"fade-up\" data-aos-delay=\"200\">\r\n <h2 class=\"accordion-header\">\r\n <button class=\"accordion-button collapsed\" type=\"button\" data-bs-toggle=\"collapse\" data-bs-target=\"#disc\">\r\n 3. Discussion\r\n <\/button>\r\n <\/h2>\r\n <div id=\"disc\" class=\"accordion-collapse collapse\">\r\n <div class=\"accordion-body\">\r\n This case illustrates a classic presentation of small bowel obstruction with an unusual etiology for the age group. The presence of blood on DRE is a hallmark of intussusception, seen in 50-60%of cases, which heavily biased the initial diagnostic impression. However, Meckel\u2019s diverticulum with a persistent band is a well documented but less common cause of obstruction, particularly in older children and adults.<br><br>\r\n The pathophysiology involves the persistence of the omphalomesenteric duct as a fibrous cord, creating a fixed point around which small bowel loops can twist or become directly entrapped, as seen in this case. This can lead to rapid progression to strangulation and necrosis, making early intervention critical. The management is always surgical. The standard procedure involves laparotomy, lysis of band and resection of diverticulum. The choice of anastomosis depends upon the local condition of bowel and surgeon preference. An ileo-transverse anastomosis ,as performed here, is a safe option to avoid tension and narrowing at the resection site.<br><br>\r\n The key learning points are:<br>\r\n \u00b7 Differential diagnosis: In any child with intestinal obstruction, congenital bands, including those from Meckel\u2019s diverticulum, should be considered even when presentation suggests a more common condition like intussusception.<br>\r\n \u00b7 Importance of exploration: When clinical and simple radiographic evidence points to complete obstruction, timely laparotomy remains both diagnostic and therapeutic.<br>\r\n \u00b7 Surgical strategy: Simple band division with diverticulectomy and careful anastomosis provides an excellent outcome, as demonstrated by the patient\u2019s uneventful recovery.\r\n <\/div>\r\n <\/div>\r\n <\/div>\r\n\r\n <div class=\"accordion-item\" data-aos=\"fade-up\" data-aos-delay=\"300\">\r\n <h2 class=\"accordion-header\">\r\n <button class=\"accordion-button collapsed\" type=\"button\" data-bs-toggle=\"collapse\" data-bs-target=\"#conc\">\r\n 4. Conclusion\r\n <\/button>\r\n <\/h2>\r\n <div id=\"conc\" class=\"accordion-collapse collapse\">\r\n <div class=\"accordion-body\">\r\n Although intussusception is the foremost concern in a toddler with intestinal obstruction and rectal bleeding, this case highlights Meckel\u2019s diverticulum and its associated band as an important surgical differential. A high clinical index of suspicion, prompt surgical intervention, and appropriate resection are paramount for successful management and prevention of catastrophic complications like bowel necrosis. This case reinforces the principle that congenital anomalies must be considered in the spectrum of pediatric acute abdomen.\r\n <\/div>\r\n <\/div>\r\n <\/div>\r\n <\/div>\r\n\r\n <\/div>\r\n\r\n \r\n <script src=\"https:\/\/cdn.jsdelivr.net\/npm\/bootstrap@5.3.3\/dist\/js\/bootstrap.bundle.min.js\"><\/script>\r\n <script src=\"https:\/\/unpkg.com\/aos@2.3.1\/dist\/aos.js\"><\/script>\r\n <script>\r\n AOS.init({ duration: 1200, once: false, mirror: true });\r\n <\/script>\r\n<\/body>\r\n<\/html>\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Intestinal Obstruction in Toddler – Meckel\u2019s Band Case Intestinal Obstruction in a Toddler Due to a Meckel\u2019s Band A Case of Diagnostic Challenge and Successful Surgical Management Abstract Introduction: Intestinal obstruction in toddlers presents a diagnostic dilemma, with common causes being intussusception, hernias and congenital anomalies. Meckel\u2019s diverticulum, though a common congenital anomaly, typically presents […]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-149","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/thekidssurgeon.com\/index.php\/wp-json\/wp\/v2\/pages\/149","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/thekidssurgeon.com\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/thekidssurgeon.com\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/thekidssurgeon.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/thekidssurgeon.com\/index.php\/wp-json\/wp\/v2\/comments?post=149"}],"version-history":[{"count":5,"href":"https:\/\/thekidssurgeon.com\/index.php\/wp-json\/wp\/v2\/pages\/149\/revisions"}],"predecessor-version":[{"id":158,"href":"https:\/\/thekidssurgeon.com\/index.php\/wp-json\/wp\/v2\/pages\/149\/revisions\/158"}],"wp:attachment":[{"href":"https:\/\/thekidssurgeon.com\/index.php\/wp-json\/wp\/v2\/media?parent=149"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}

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\n\t\t\t\t\t\r\n\r\n\r\n \r\n \r\n Intestinal Obstruction in Toddler - Meckel\u2019s Band Case<\/title>\r\n \r\n \r\n <link href=\"https:\/\/cdn.jsdelivr.net\/npm\/bootstrap@5.3.3\/dist\/css\/bootstrap.min.css\" rel=\"stylesheet\">\r\n \r\n \r\n <link rel=\"stylesheet\" href=\"https:\/\/cdnjs.cloudflare.com\/ajax\/libs\/font-awesome\/6.5.0\/css\/all.min.css\">\r\n \r\n \r\n <link href=\"https:\/\/unpkg.com\/aos@2.3.1\/dist\/aos.css\" rel=\"stylesheet\">\r\n \r\n <style>\r\n body { \r\n background: linear-gradient(-45deg, #e0f7fa, #b2ebf2, #80deea, #4dd0e1);\r\n background-size: 400% 400%;\r\n animation: gradientBG 15s ease infinite;\r\n font-family: 'Segoe UI', Tahoma, Geneva, Verdana, sans-serif; \r\n color: #2c3e50; \r\n min-height: 100vh;\r\n }\r\n @keyframes gradientBG {\r\n 0% { background-position: 0% 50%; }\r\n 50% { background-position: 100% 50%; }\r\n 100% { background-position: 0% 50%; }\r\n }\r\n .header { \r\n background: linear-gradient(135deg, #007bff, #6610f2, #e91e63); \r\n color: white; \r\n padding: 100px 20px; \r\n text-align: center; \r\n border-radius: 0 0 60px 60px; \r\n box-shadow: 0 20px 40px rgba(0,0,0,0.3); \r\n }\r\n .header h1 {\r\n animation: bounceIn 1.8s ease;\r\n }\r\n @keyframes bounceIn {\r\n 0% { transform: scale(0.6); opacity: 0; }\r\n 60% { transform: scale(1.15); opacity: 1; }\r\n 100% { transform: scale(1); }\r\n }\r\n .section-card, .awareness-box { \r\n border-radius: 25px; \r\n box-shadow: 0 15px 35px rgba(0,0,0,0.2); \r\n transition: all 0.5s ease;\r\n background: white;\r\n }\r\n .section-card:hover, .awareness-box:hover {\r\n transform: translateY(-12px);\r\n box-shadow: 0 25px 50px rgba(0,123,255,0.3);\r\n }\r\n .awareness-box { \r\n background: linear-gradient(135deg, #fff176, #ffe082); \r\n border: 5px solid #ffca28; \r\n padding: 35px; \r\n animation: heartbeat 2.5s infinite;\r\n }\r\n @keyframes heartbeat {\r\n 0%, 100% { transform: scale(1); }\r\n 50% { transform: scale(1.04); }\r\n }\r\n .img-container {\r\n position: relative;\r\n overflow: hidden;\r\n border-radius: 20px;\r\n box-shadow: 0 10px 25px rgba(0,0,0,0.2);\r\n }\r\n .img-container img {\r\n transition: all 0.7s ease;\r\n width: 100%;\r\n }\r\n .img-container:hover img {\r\n transform: scale(1.12) rotate(4deg);\r\n }\r\n .emoji { font-size: 2.5rem; margin-right: 15px; }\r\n .accordion-button:not(.collapsed) {\r\n background: linear-gradient(to right, #0d6efd, #6610f2);\r\n color: white;\r\n }\r\n <\/style>\r\n<\/head>\r\n<body>\r\n\r\n <div class=\"header\" data-aos=\"zoom-in-down\" data-aos-duration=\"1500\">\r\n <h1 class=\"display-4 fw-bold\"><i class=\"fas fa-heartbeat me-3\"><\/i> Intestinal Obstruction in a Toddler Due to a Meckel\u2019s Band<\/h1>\r\n <p class=\"lead fs-4\">A Case of Diagnostic Challenge and Successful Surgical Management<\/p>\r\n <\/div>\r\n\r\n <div class=\"container my-5\">\r\n\r\n \r\n <div class=\"card section-card mb-5\" data-aos=\"fade-up\">\r\n <div class=\"card-body p-5\">\r\n <h2 class=\"text-primary mb-4\"><i class=\"fas fa-file-medical\"><\/i> Abstract<\/h2>\r\n <p><strong>Introduction:<\/strong> Intestinal obstruction in toddlers presents a diagnostic dilemma, with common causes being intussusception, hernias and congenital anomalies. Meckel\u2019s diverticulum, though a common congenital anomaly, typically presents with painless rectal bleeding. Its complications, like a persistent vitellointestinal band (Meckel\u2019s band), causing acute mechanical obstruction are a rarer clinical entity.<\/p>\r\n <p><strong>Case Presentation:<\/strong> We report a case of a 16-month old female who presented with a 7-days history of progressive abdominal distension, 4 days of bilious vomiting and 4 days of absolute constipation. Digital rectal examination revealed finger stained with blood, initially raising suspicion for intussusception.<\/p>\r\n <p><strong>Management and outcome:<\/strong> Emergency laparotomy revealed a congenital band extending from a Meckel\u2019s diverticulum to the umbilicus, causing a closed loop obstruction of the distal ileum. A wedge resection of the diverticulum with ileo-transverse anastomosis was performed. The postoperative course was uneventful. The patient was managed with nothing per oral and intravenous fluid for 5 days, with a drain in situ. She was discharged on the 6th postoperative day in good health, with no wound infection.<\/p>\r\n <p><strong>Conclusion:<\/strong> This case underscores that while intussusception is a prime consideration in a toddler with intestinal obstruction and rectal bleeding, congenital bands from a Meckel\u2019s diverticulum must remain a vital differential diagnosis. A high index of suspicion and timely surgical intervention are crucial for a favorable outcome.<\/p>\r\n <\/div>\r\n <\/div>\r\n\r\n \r\n <div class=\"row g-4 mb-5\">\r\n <div class=\"col-md-4\" data-aos=\"flip-left\">\r\n <div class=\"img-container\">\r\n <img decoding=\"async\" src=\"https:\/\/upload.wikimedia.org\/wikipedia\/commons\/f\/fe\/Diverticule_de_Meckel.jpg\" alt=\"Meckel's Diverticulum\">\r\n <\/div>\r\n <\/div>\r\n <div class=\"col-md-4\" data-aos=\"flip-up\">\r\n <div class=\"img-container\">\r\n <img decoding=\"async\" src=\"https:\/\/image.slidesharecdn.com\/meckelsdiverticulum-170505174554\/75\/Meckel-s-diverticulum-11-2048.jpg\" alt=\"Meckel's Band Illustration\">\r\n <\/div>\r\n <\/div>\r\n <div class=\"col-md-4\" data-aos=\"flip-right\">\r\n <div class=\"img-container\">\r\n <img decoding=\"async\" src=\"https:\/\/thumbs.dreamstime.com\/b\/cute-girl-stomachache-have-friend-soothe-66480222.jpg\" alt=\"Child with Stomach Pain Cartoon\">\r\n <\/div>\r\n <\/div>\r\n <\/div>\r\n\r\n \r\n <div class=\"awareness-box mb-5\" data-aos=\"zoom-in\">\r\n <h3 class=\"fw-bold mb-4\"><i class=\"fas fa-baby\"><\/i> \u09b6\u09bf\u09b6\u09c1\u09a4\u09c7 \u0985\u09a8\u09cd\u09a4\u09cd\u09b0\u09c7\u09b0 \u09ac\u09be\u09a7\u09be: \u09ae\u09c7\u0995\u09c7\u09b2\u09c7\u09b0 \u09ac\u09cd\u09af\u09be\u09a8\u09cd\u09a1\u09c7\u09b0 \u0995\u09be\u09b0\u09a3\u09c7 \u098f\u0995 \u0998\u099f\u09a8\u09be<\/h3>\r\n <p><strong>\ud83d\udc76 \u0998\u099f\u09a8\u09be\u09b0 \u09b8\u09be\u09b0\u09b8\u0982\u0995\u09cd\u09b7\u09c7\u09aa:<\/strong> \u098f\u0995\u099c\u09a8 \u09e7\u09ec \u09ae\u09be\u09b8 \u09ac\u09af\u09bc\u09b8\u09c0 \u09ae\u09c7\u09af\u09bc\u09c7\u09b6\u09bf\u09b6\u09c1 \u09b9\u09a0\u09be\u09ce \u0995\u09b0\u09c7 \u09a4\u09c0\u09ac\u09cd\u09b0 \u09aa\u09c7\u099f \u09ab\u09be\u0981\u09aa\u09be, \u09ac\u09ae\u09bf (\u09b8\u09ac\u09c1\u099c\u09be\u09ad\/\u09aa\u09bf\u09a4\u09cd\u09a4 \u09ae\u09bf\u09b6\u09cd\u09b0\u09bf\u09a4), \u098f\u09ac\u0982 \u0995\u09af\u09bc\u09c7\u0995\u09a6\u09bf\u09a8 \u09a7\u09b0\u09c7 \u09ae\u09b2 \u09a8\u09be \u09b9\u0993\u09af\u09bc\u09be\u09b0 \u09b8\u09ae\u09b8\u09cd\u09af\u09be\u09af\u09bc \u09ad\u09c1\u0997\u099b\u09bf\u09b2\u0964 \u09a1\u09be\u0995\u09cd\u09a4\u09be\u09b0\u09b0\u09be \u09aa\u09cd\u09b0\u09a5\u09ae\u09c7 \u09ad\u09c7\u09ac\u09c7\u099b\u09bf\u09b2\u09c7\u09a8 \u098f\u099f\u09bf \u0987\u09a8\u099f\u09c1\u09b8\u09be\u09b8\u09c7\u09aa\u09b6\u09a8 (\u0985\u09a8\u09cd\u09a4\u09cd\u09b0\u09c7\u09b0 \u09ad\u09c7\u09a4\u09b0\u09c7 \u0985\u09a8\u09cd\u09a4\u09cd\u09b0 \u09a2\u09c1\u0995\u09c7 \u09af\u09be\u0993\u09af\u09bc\u09be), \u0995\u09be\u09b0\u09a3 \u09b6\u09bf\u09b6\u09c1\u09b0 \u09ae\u09b2\u09a6\u09cd\u09ac\u09be\u09b0 \u09aa\u09b0\u09c0\u0995\u09cd\u09b7\u09be \u0995\u09b0\u09b2\u09c7 \u09b0\u0995\u09cd\u09a4 \u09ae\u09bf\u09b6\u09cd\u09b0\u09bf\u09a4 \u09b6\u09cd\u09b2\u09c7\u09b7\u09cd\u09ae\u09be \u09aa\u09be\u0993\u09af\u09bc\u09be \u09af\u09be\u09af\u09bc\u0964<\/p>\r\n <p><strong>\ud83d\udd0e \u0985\u09aa\u09be\u09b0\u09c7\u09b6\u09a8\u09c7 \u0995\u09c0 \u09aa\u09be\u0993\u09af\u09bc\u09be \u0997\u09c7\u09b2:<\/strong> \u09b6\u09bf\u09b6\u09c1\u09b0 \u09aa\u09c7\u099f\u09c7 \u0985\u09b8\u09cd\u09a4\u09cd\u09b0\u09cb\u09aa\u099a\u09be\u09b0 \u0995\u09b0\u09b2\u09c7 \u09a6\u09c7\u0996\u09be \u09af\u09be\u09af\u09bc \u098f\u0995\u099f\u09bf \u099c\u09a8\u09cd\u09ae\u0997\u09a4 \u09ab\u09be\u0987\u09ac\u09be\u09b0 \u09ac\u09cd\u09af\u09be\u09a8\u09cd\u09a1 (\u09ae\u09c7\u0995\u09c7\u09b2\u09c7\u09b0 \u09ac\u09cd\u09af\u09be\u09a8\u09cd\u09a1) \u09ae\u09c7\u0995\u09c7\u09b2\u09c7\u09b0 \u09a1\u09be\u0987\u09ad\u09be\u09b0\u09cd\u099f\u09bf\u0995\u09c1\u09b2\u09be\u09ae \u09a5\u09c7\u0995\u09c7 \u09a8\u09be\u09ad\u09bf\u09b0 \u09a6\u09bf\u0995\u09c7 \u0997\u09bf\u09af\u09bc\u09c7\u099b\u09c7\u0964 \u098f\u0987 \u09ac\u09cd\u09af\u09be\u09a8\u09cd\u09a1\u09c7\u09b0 \u09a8\u09bf\u099a\u09c7 \u0985\u09a8\u09cd\u09a4\u09cd\u09b0 \u0986\u099f\u0995\u09c7 \u0997\u09bf\u09af\u09bc\u09c7 \u09b8\u09ae\u09cd\u09aa\u09c2\u09b0\u09cd\u09a3 \u09ac\u09cd\u09b2\u0995 \u09b9\u09af\u09bc\u09c7 \u09af\u09be\u09af\u09bc \u098f\u09ac\u0982 \u0995\u09bf\u099b\u09c1 \u0985\u0982\u09b6\u09c7 \u0985\u09a8\u09cd\u09a4\u09cd\u09b0 \u09a8\u09b7\u09cd\u099f \u09b9\u09af\u09bc\u09c7 \u0997\u09c7\u099b\u09c7\u0964<\/p>\r\n <p><strong>\u2695\ufe0f \u099a\u09bf\u0995\u09bf\u09ce\u09b8\u09be:<\/strong> \u09ac\u09cd\u09af\u09be\u09a8\u09cd\u09a1 \u0995\u09c7\u099f\u09c7 \u09ab\u09c7\u09b2\u09be \u09b9\u09af\u09bc\u0964 \u09ae\u09c7\u0995\u09c7\u09b2\u09c7\u09b0 \u09a1\u09be\u0987\u09ad\u09be\u09b0\u09cd\u099f\u09bf\u0995\u09c1\u09b2\u09be\u09ae \u0985\u0982\u09b6 \u0995\u09c7\u099f\u09c7 \u09ac\u09be\u09a6 \u09a6\u09c7\u0993\u09af\u09bc\u09be \u09b9\u09af\u09bc\u0964 \u09a8\u09b7\u09cd\u099f \u09b9\u0993\u09af\u09bc\u09be \u0985\u09a8\u09cd\u09a4\u09cd\u09b0\u09c7\u09b0 \u0985\u0982\u09b6 \u0995\u09c7\u099f\u09c7 \u09ab\u09c7\u09b2\u09c7 \u09b8\u09c1\u09b8\u09cd\u09a5 \u0985\u09a8\u09cd\u09a4\u09cd\u09b0\u09c7\u09b0 \u09b8\u09be\u09a5\u09c7 \u099c\u09cb\u09a1\u09bc\u09be \u09b2\u09be\u0997\u09be\u09a8\u09cb \u09b9\u09af\u09bc\u0964 \u0985\u09b8\u09cd\u09a4\u09cd\u09b0\u09cb\u09aa\u099a\u09be\u09b0\u09c7\u09b0 \u09aa\u09b0 \u09b6\u09bf\u09b6\u09c1\u099f\u09bf \u09a6\u09cd\u09b0\u09c1\u09a4 \u09b8\u09c1\u09b8\u09cd\u09a5 \u09b9\u09af\u09bc\u09c7 \u0993\u09a0\u09c7 \u098f\u09ac\u0982 \u09ec\u09b7\u09cd\u09a0 \u09a6\u09bf\u09a8\u09c7 \u09b9\u09be\u09b8\u09aa\u09be\u09a4\u09be\u09b2 \u09a5\u09c7\u0995\u09c7 \u099b\u09be\u09a1\u09bc\u09be \u09aa\u09be\u09af\u09bc\u0964<\/p>\r\n <p><strong>\ud83d\udccc \u09ae\u09c2\u09b2 \u09b6\u09bf\u0995\u09cd\u09b7\u09be:<\/strong> \u099b\u09cb\u099f \u09b6\u09bf\u09b6\u09c1\u09a6\u09c7\u09b0 \u09aa\u09c7\u099f\u09c7 \u09b9\u09a0\u09be\u09ce \u09ac\u09be\u09a7\u09be \u09b9\u09b2\u09c7 \u09b6\u09c1\u09a7\u09c1 \u0987\u09a8\u099f\u09c1\u09b8\u09be\u09b8\u09c7\u09aa\u09b6\u09a8 \u09a8\u09af\u09bc, \u099c\u09a8\u09cd\u09ae\u0997\u09a4 \u09ac\u09cd\u09af\u09be\u09a8\u09cd\u09a1 \u09ac\u09be \u09ae\u09c7\u0995\u09c7\u09b2\u09c7\u09b0 \u09a1\u09be\u0987\u09ad\u09be\u09b0\u09cd\u099f\u09bf\u0995\u09c1\u09b2\u09be\u09ae\u0993 \u0995\u09be\u09b0\u09a3 \u09b9\u09a4\u09c7 \u09aa\u09be\u09b0\u09c7\u0964 \u09b8\u09ae\u09af\u09bc\u09ae\u09a4\u09cb \u0985\u09b8\u09cd\u09a4\u09cd\u09b0\u09cb\u09aa\u099a\u09be\u09b0 \u0995\u09b0\u09b2\u09c7 \u099c\u09c0\u09ac\u09a8 \u09ac\u09be\u0981\u099a\u09be\u09a8\u09cb \u09b8\u09ae\u09cd\u09ad\u09ac\u0964<\/p>\r\n <\/div>\r\n\r\n \r\n <div class=\"row g-4 mb-5\">\r\n <div class=\"col-md-6\" data-aos=\"fade-up\">\r\n <div class=\"img-container\">\r\n <img decoding=\"async\" src=\"https:\/\/thumbs.dreamstime.com\/b\/children-get-sick-isolated-white-background-child-has-high-temperature-boy-hit-hammer-finger-toothache-boy-s-stomach-ache-83589714.jpg\" alt=\"Child Stomach Ache Cartoon\">\r\n <\/div>\r\n <\/div>\r\n <div class=\"col-md-6\" data-aos=\"fade-up\" data-aos-delay=\"200\">\r\n <div class=\"img-container\">\r\n <img decoding=\"async\" src=\"https:\/\/www.shutterstock.com\/shutterstock\/photos\/2720740361\/display_1500\/stock-vector-little-girl-cries-and-holds-her-stomach-in-pain-representing-common-childhood-illnesses-like-food-2720740361.jpg\" alt=\"Girl Holding Stomach in Pain\">\r\n <\/div>\r\n <\/div>\r\n <\/div>\r\n\r\n \r\n <div class=\"alert alert-warning awareness-box mb-5\" role=\"alert\" data-aos=\"pulse\">\r\n <h4 class=\"alert-heading\"><i class=\"fas fa-exclamation-triangle me-2\"><\/i> \u099c\u09a8\u09b8\u099a\u09c7\u09a4\u09a8\u09a4\u09be \u09ac\u09be\u09b0\u09cd\u09a4\u09be \ud83e\ude7a<\/h4>\r\n <p>\u099b\u09cb\u099f \u09b6\u09bf\u09b6\u09c1\u09a6\u09c7\u09b0 \u09b9\u09a0\u09be\u09ce \u09aa\u09c7\u099f \u09ab\u09be\u0981\u09aa\u09be, \u09ac\u09ae\u09bf (\u09ac\u09bf\u09b6\u09c7\u09b7 \u0995\u09b0\u09c7 \u09b8\u09ac\u09c1\u099c\u09be\u09ad \u09ac\u09be \u09aa\u09bf\u09a4\u09cd\u09a4 \u09ae\u09bf\u09b6\u09cd\u09b0\u09bf\u09a4), \u098f\u09ac\u0982 \u0995\u09af\u09bc\u09c7\u0995\u09a6\u09bf\u09a8 \u09a7\u09b0\u09c7 \u09ae\u09b2 \u09a8\u09be \u09b9\u0993\u09af\u09bc\u09be \u0985\u09a8\u09cd\u09a4\u09cd\u09b0\u09c7 \u09ac\u09be\u09a7\u09be\u09b0 \u09b2\u0995\u09cd\u09b7\u09a3 \u09b9\u09a4\u09c7 \u09aa\u09be\u09b0\u09c7\u0964 \u0985\u09a8\u09c7\u0995 \u09b8\u09ae\u09af\u09bc \u09a1\u09be\u0995\u09cd\u09a4\u09be\u09b0\u09b0\u09be \u09aa\u09cd\u09b0\u09a5\u09ae\u09c7 \u09ae\u09a8\u09c7 \u0995\u09b0\u09c7\u09a8 \u098f\u099f\u09bf \u0987\u09a8\u099f\u09c1\u09b8\u09be\u09b8\u09c7\u09aa\u09b6\u09a8, \u0995\u09bf\u09a8\u09cd\u09a4\u09c1 \u0995\u09bf\u099b\u09c1 \u0995\u09cd\u09b7\u09c7\u09a4\u09cd\u09b0\u09c7 \u099c\u09a8\u09cd\u09ae\u0997\u09a4 \u0985\u09b8\u09cd\u09ac\u09be\u09ad\u09be\u09ac\u09bf\u0995\u09a4\u09be \u09af\u09c7\u09ae\u09a8 \u09ae\u09c7\u0995\u09c7\u09b2\u09c7\u09b0 \u09ac\u09cd\u09af\u09be\u09a8\u09cd\u09a1 \u0985\u09a8\u09cd\u09a4\u09cd\u09b0\u0995\u09c7 \u0986\u099f\u0995\u09c7 \u09a6\u09bf\u09af\u09bc\u09c7 \u09ae\u09be\u09b0\u09be\u09a4\u09cd\u09ae\u0995 \u09ac\u09be\u09a7\u09be \u09b8\u09c3\u09b7\u09cd\u099f\u09bf \u0995\u09b0\u09a4\u09c7 \u09aa\u09be\u09b0\u09c7\u0964 \u098f\u0987 \u0985\u09ac\u09b8\u09cd\u09a5\u09be\u09af\u09bc \u0985\u09a8\u09cd\u09a4\u09cd\u09b0 \u09a6\u09cd\u09b0\u09c1\u09a4 \u09a8\u09b7\u09cd\u099f \u09b9\u09af\u09bc\u09c7 \u09af\u09c7\u09a4\u09c7 \u09aa\u09be\u09b0\u09c7\u0964<\/p>\r\n <p><strong>\u26a0\ufe0f \u0995\u09bf \u0995\u09b0\u09a4\u09c7 \u09b9\u09ac\u09c7:<\/strong> \u09b6\u09bf\u09b6\u09c1\u09b0 \u09aa\u09c7\u099f\u09c7 \u09b9\u09a0\u09be\u09ce \u09ab\u09be\u0981\u09aa\u09be, \u09ac\u09ae\u09bf, \u09ae\u09b2 \u09a8\u09be \u09b9\u0993\u09af\u09bc\u09be \u09ac\u09be \u09b0\u0995\u09cd\u09a4 \u09ae\u09bf\u09b6\u09cd\u09b0\u09bf\u09a4 \u09b6\u09cd\u09b2\u09c7\u09b7\u09cd\u09ae\u09be \u09a6\u09c7\u0996\u09be \u09a6\u09bf\u09b2\u09c7 \u09a6\u09c7\u09b0\u09bf \u09a8\u09be \u0995\u09b0\u09c7 \u09a6\u09cd\u09b0\u09c1\u09a4 \u09b9\u09be\u09b8\u09aa\u09be\u09a4\u09be\u09b2\u09c7 \u09a8\u09bf\u09af\u09bc\u09c7 \u09af\u09be\u09a8\u0964 \u09b8\u09ae\u09af\u09bc\u09ae\u09a4\u09cb \u0985\u09b8\u09cd\u09a4\u09cd\u09b0\u09cb\u09aa\u099a\u09be\u09b0 \u0995\u09b0\u09b2\u09c7 \u09b6\u09bf\u09b6\u09c1\u09b0 \u099c\u09c0\u09ac\u09a8 \u09ac\u09be\u0981\u099a\u09be\u09a8\u09cb \u09b8\u09ae\u09cd\u09ad\u09ac\u0964<\/p>\r\n <p><strong>\ud83d\udca1 \u09ae\u09c2\u09b2 \u09ac\u09be\u09b0\u09cd\u09a4\u09be:<\/strong> \u09b6\u09bf\u09b6\u09c1\u09b0 \u09aa\u09c7\u099f\u09c7\u09b0 \u09b8\u09ae\u09b8\u09cd\u09af\u09be\u0995\u09c7 \u09b9\u09be\u09b2\u0995\u09be\u09ad\u09be\u09ac\u09c7 \u09a8\u09c7\u09ac\u09c7\u09a8 \u09a8\u09be\u0964 \u09a6\u09cd\u09b0\u09c1\u09a4 \u099a\u09bf\u0995\u09bf\u09ce\u09b8\u09be \u09a8\u09bf\u09b2\u09c7 \u099c\u099f\u09bf\u09b2\u09a4\u09be \u098f\u09a1\u09bc\u09be\u09a8\u09cb \u09af\u09be\u09af\u09bc\u0964<\/p>\r\n <\/div>\r\n\r\n \r\n <div class=\"accordion shadow\" id=\"caseAccordion\">\r\n <div class=\"accordion-item\" data-aos=\"fade-up\">\r\n <h2 class=\"accordion-header\">\r\n <button class=\"accordion-button\" type=\"button\" data-bs-toggle=\"collapse\" data-bs-target=\"#intro\">\r\n 1. Introduction\r\n <\/button>\r\n <\/h2>\r\n <div id=\"intro\" class=\"accordion-collapse collapse show\">\r\n <div class=\"accordion-body\">\r\n Acute intestinal obstruction in infants and toddlers is a surgical emergency. The leading causes include intussusception, incarcerated inguinal hernia, and intestinal atresia like duodenal web. Meckel\u2019s diverticulum, a remnant of the omphalomesenteric duct, is the most prevalent congenital gastrointestinal anomaly, found in approximately 2 %of the population. while often asymptomatic, its complications can include hemorrhage, diverticulitis and intestinal obstruction. Obstruction typically occurs due to intussusception, volvulus around a fibrous band connecting the diverticulum to the umbilicus or incarceration with a hernia (Littre\u2019s hernia). We present a case of a 16 month old girl where a Meckel\u2019s band caused a complete small bowel obstruction, mimicking the classic presentation of intussusception.\r\n <\/div>\r\n <\/div>\r\n <\/div>\r\n\r\n <div class=\"accordion-item\" data-aos=\"fade-up\" data-aos-delay=\"100\">\r\n <h2 class=\"accordion-header\">\r\n <button class=\"accordion-button collapsed\" type=\"button\" data-bs-toggle=\"collapse\" data-bs-target=\"#case\">\r\n 2. Case Presentation\r\n <\/button>\r\n <\/h2>\r\n <div id=\"case\" class=\"accordion-collapse collapse\">\r\n <div class=\"accordion-body\">\r\n <strong>2.1. Patient information:<\/strong> A 16-month old previously healthy female infant, wt-10 kg presented to the emergency department.<br><br>\r\n <strong>2.2. Clinical History:<\/strong> The parents reported a 7 days history of increasing abdominal distension, associated with irritability and poor feeding and intermittent crying. This progressed to bilious vomiting for the last 4 days. There was no passage of stool for 4 days only few blood stained mucous like material came out. There was no history of fever, trauma, diarrhoea or similar episodes in the past.<br><br>\r\n <strong>2.3. Clinical findings:<\/strong> On examination: The child was irritable, tachycardiac and mildly dehydrated. The abdomen was markedly distended later, tense and tender on palpation, with no palpable mass. Bowel sounds were hyperactive initially but become sluggish later. Digital Rectal Examination: Revealed an empty rectal ampulla with the examining finger stained with mucous mixed blood.<br><br>\r\n <strong>2.4. Diagnostic Assessment:<\/strong> Based on the clinical triad of abdominal distension, bilious vomiting and constipation, a diagnosis of acute intestinal obstruction was made. The finding of blood on DRE, along with the age of the patient, made intussusception the leading preoperative diagnosis. An abdominal ultrasound was performed which shows no target sign but revealed dilated small bowel loops with fluid level. Given the clinical picture of complete obstruction, the decision was made for an emergency exploratory laparotomy.<br><br>\r\n <strong>2.5. Therapeutic Intervention:<\/strong> A Transverse supraumbilical (Rt) incision was given. Intraoperative findings revealed a grossly dilated proximal small bowel and collapsed distal bowel. A fibrous band (Meckel\u2019s band) was identified, extending from the tip of a Meckel\u2019s diverticulum to the mesentery. A loop of distal ileum was entrapped under this band, causing a tight, closed loop obstruction. There was no evidence of intussusception but bowel was necrosed at the part where fibrous band compressed the gut which is about 5 cm proximal to the ileo-cecal valve. The band was lysed. A wedge resection of the Meckel\u2019s diverticulum at its base on the antimesenteric border was performed, followed by resection of the gangrenous part upto ascending colon and end to end anastomosis was done. A drain was placed in the pelvis.\r\n <\/div>\r\n <\/div>\r\n <\/div>\r\n\r\n <div class=\"accordion-item\" data-aos=\"fade-up\" data-aos-delay=\"200\">\r\n <h2 class=\"accordion-header\">\r\n <button class=\"accordion-button collapsed\" type=\"button\" data-bs-toggle=\"collapse\" data-bs-target=\"#disc\">\r\n 3. Discussion\r\n <\/button>\r\n <\/h2>\r\n <div id=\"disc\" class=\"accordion-collapse collapse\">\r\n <div class=\"accordion-body\">\r\n This case illustrates a classic presentation of small bowel obstruction with an unusual etiology for the age group. The presence of blood on DRE is a hallmark of intussusception, seen in 50-60%of cases, which heavily biased the initial diagnostic impression. However, Meckel\u2019s diverticulum with a persistent band is a well documented but less common cause of obstruction, particularly in older children and adults.<br><br>\r\n The pathophysiology involves the persistence of the omphalomesenteric duct as a fibrous cord, creating a fixed point around which small bowel loops can twist or become directly entrapped, as seen in this case. This can lead to rapid progression to strangulation and necrosis, making early intervention critical. The management is always surgical. The standard procedure involves laparotomy, lysis of band and resection of diverticulum. The choice of anastomosis depends upon the local condition of bowel and surgeon preference. An ileo-transverse anastomosis ,as performed here, is a safe option to avoid tension and narrowing at the resection site.<br><br>\r\n The key learning points are:<br>\r\n \u00b7 Differential diagnosis: In any child with intestinal obstruction, congenital bands, including those from Meckel\u2019s diverticulum, should be considered even when presentation suggests a more common condition like intussusception.<br>\r\n \u00b7 Importance of exploration: When clinical and simple radiographic evidence points to complete obstruction, timely laparotomy remains both diagnostic and therapeutic.<br>\r\n \u00b7 Surgical strategy: Simple band division with diverticulectomy and careful anastomosis provides an excellent outcome, as demonstrated by the patient\u2019s uneventful recovery.\r\n <\/div>\r\n <\/div>\r\n <\/div>\r\n\r\n <div class=\"accordion-item\" data-aos=\"fade-up\" data-aos-delay=\"300\">\r\n <h2 class=\"accordion-header\">\r\n <button class=\"accordion-button collapsed\" type=\"button\" data-bs-toggle=\"collapse\" data-bs-target=\"#conc\">\r\n 4. Conclusion\r\n <\/button>\r\n <\/h2>\r\n <div id=\"conc\" class=\"accordion-collapse collapse\">\r\n <div class=\"accordion-body\">\r\n Although intussusception is the foremost concern in a toddler with intestinal obstruction and rectal bleeding, this case highlights Meckel\u2019s diverticulum and its associated band as an important surgical differential. A high clinical index of suspicion, prompt surgical intervention, and appropriate resection are paramount for successful management and prevention of catastrophic complications like bowel necrosis. This case reinforces the principle that congenital anomalies must be considered in the spectrum of pediatric acute abdomen.\r\n <\/div>\r\n <\/div>\r\n <\/div>\r\n <\/div>\r\n\r\n <\/div>\r\n\r\n \r\n <script src=\"https:\/\/cdn.jsdelivr.net\/npm\/bootstrap@5.3.3\/dist\/js\/bootstrap.bundle.min.js\"><\/script>\r\n <script src=\"https:\/\/unpkg.com\/aos@2.3.1\/dist\/aos.js\"><\/script>\r\n <script>\r\n AOS.init({ duration: 1200, once: false, mirror: true });\r\n <\/script>\r\n<\/body>\r\n<\/html>\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Intestinal Obstruction in Toddler – Meckel\u2019s Band Case Intestinal Obstruction in a Toddler Due to a Meckel\u2019s Band A Case of Diagnostic Challenge and Successful Surgical Management Abstract Introduction: Intestinal obstruction in toddlers presents a diagnostic dilemma, with common causes being intussusception, hernias and congenital anomalies. Meckel\u2019s diverticulum, though a common congenital anomaly, typically presents […]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-149","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/thekidssurgeon.com\/index.php\/wp-json\/wp\/v2\/pages\/149","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/thekidssurgeon.com\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/thekidssurgeon.com\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/thekidssurgeon.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/thekidssurgeon.com\/index.php\/wp-json\/wp\/v2\/comments?post=149"}],"version-history":[{"count":5,"href":"https:\/\/thekidssurgeon.com\/index.php\/wp-json\/wp\/v2\/pages\/149\/revisions"}],"predecessor-version":[{"id":158,"href":"https:\/\/thekidssurgeon.com\/index.php\/wp-json\/wp\/v2\/pages\/149\/revisions\/158"}],"wp:attachment":[{"href":"https:\/\/thekidssurgeon.com\/index.php\/wp-json\/wp\/v2\/media?parent=149"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}