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Case Report: Laparoscopy-assisted trans-umbilical Meckel's diverticulectomy for Meckel's diverticulum complicated by internal hernia: a three-case series and narrative literature review
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DOI：10.3389/fped.2026.1752428.png)
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Abstract
En 中文
Background Meckel's diverticulum (MD) is the most prevalent congenital anomaly of the small intestine. Internal hernia secondary to MD is extremely rare in children and poses a diagnostic and therapeutic challenge. Case presentation We report three consecutive paediatric cases successfully managed by laparoscopy-assisted trans-umbilical Meckel's diverticulectomy (LATUM) and provide a comprehensive review of the world literature. Clinical data of three children with MD complicated by internal hernia treated between March 2023 and April 2024 were retrospectively analysed. A systematic search of PubMed, Web of Science and Google (up to June 2025) was performed to identify previously published paediatric cases. Two boys and one girl (median age: 7 years, range: 7-11) presented with acute abdominal pain and vomiting. Pre-operative imaging suggested intestinal obstruction or intussusception. Laparoscopy revealed internal hernia formed by a mesodiverticular band (MDB) in all cases. LATUM was completed without conversion. Median operative time was 65 min (range: 50-90, IQR: 55-75), estimated blood loss was 10 mL (range: 5-15, IQR: 7.5-12.5), and time to first flatus was 24 h (range 18-36, IQR 20-30). Median hospital stay was 7.5 days (7-8). No complications occurred during a median follow-up of 16 months. The literature review yielded 25 additional paediatric cases. Including our series, 28 children have been reported; 9 cases (32.14%) used LATUM, 8 cases (28.57%) used open resection, and 11 cases (39.29%) did not describe the surgical approach. Conclusion LATUM offers a safe, minimally invasive and cosmetically superior option for children with MD complicated by internal hernia. A high index of suspicion and early laparoscopy are crucial to avoid bowel necrosis.
Keywords:
hernia
internal
LATUM
Meckel's diverticulum
pediatric
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