title: Severe acute abdomen caused by symptomatic Meckel's diverticulum in three children with trisomy 18.
abstract: Meckel's diverticulum (MD) is the most prevalent congenital anomaly of the gastrointestinal tract and often presents a diagnostic challenge. Patients with trisomy 18 frequently have MD, but the poor prognosis and lack of consensus regarding management for neonates has meant that precise information on the clinical manifestations in infants and children with MD is lacking. We describe the cases of three children with trisomy 18 who developed symptomatic MD. Intussusception was diagnosed in Patient 1, intestinal volvulus in Patient 2, and gastrointestinal bleeding in Patient 3. All three patients underwent surgical treatment and only the Patient 1 died due to pulmonary hypertensive crisis. The other two patients experienced no further episodes of abdominal symptoms. In patients with trisomy 18, although consideration of postoperative complications and prognosis after surgical treatment is necessary, symptomatic MD should carry a high index of suspicion in patients presenting with acute abdomen.
authors.affiliation: Department of Pediatrics, Shiga Medical Center for Children, Moriyama, Japan.
authors.forename: Anri
authors.initials: A
authors.lastname: Hayashi
authors.affiliation: Department of Pediatrics, Shiga Medical Center for Children, Moriyama, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Kumada
authors.affiliation: Department of Pediatrics, Shiga Medical College, Otus, Japan.
authors.forename: Oki
authors.initials: O
authors.lastname: Furukawa
authors.affiliation: Department of Pediatrics, Shiga Medical Center for Children, Moriyama, Japan.
authors.forename: Fumihito
authors.initials: F
authors.lastname: Nozaki
authors.affiliation: Department of Pediatrics, Shiga Medical Center for Children, Moriyama, Japan.
authors.forename: Ikuko
authors.initials: I
authors.lastname: Hiejima
authors.affiliation: Department of Pediatrics, Shiga Medical Center for Children, Moriyama, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Shibata
authors.affiliation: Department of Pediatrics, Shiga Medical Center for Children, Moriyama, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kusunoki
authors.affiliation: Department of Pediatrics, Shiga Medical Center for Children, Moriyama, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Fujii
mesh_terms: D000006:Abdomen, Acute / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology / Q000601:surgery; D002675:Child, Preschool; D002887:Chromosomes, Human, Pair 18 / Q000235:genetics; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology / Q000601:surgery; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D045822:Intestinal Volvulus / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology / Q000601:surgery; D007443:Intussusception / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology / Q000601:surgery; D008467:Meckel Diverticulum / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology / Q000601:surgery; D014314:Trisomy / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D000073842:Trisomy 18 Syndrome
keywords: 18 trisomy; Meckel's; acute abdomen; children; diverticulum