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Case Reports
The rule of two's didn't work: a case of Meckel's diverticulum with hemorrhagic shock in an adolescent.
- Hillary Spangler and Joseph Fisher.
- Department of Internal Medicine and Pediatrics, UNC Hospitals, Chapel Hill, NC, United States of America. Electronic address: Hillary.Spangler@unchealth.unc.edu.
- Am J Emerg Med. 2020 Jul 1; 38 (7): 1541.e1-1541.e2.
AbstractMeckel's diverticulum classically follows the rule of two's; presenting before the age of two years, found 2 ft. from the ileocecal valve, approximately 2 in. in length, and present in roughly 2% of the population. To our knowledge, there are few cases detailing emergent medicine management of hemorrhagic shock in patients with acute blood loss from a Meckel's diverticulum. We report the case of a 13-year-old male presenting in hemorrhagic shock secondary to an undifferentiated gastrointestinal bleed who was effectively resuscitated in a children's emergency department. Meckel's scan revealed abnormal tracer uptake consistent with Meckel's diverticulum and the patient underwent surgical resection of the diverticulum. This case report details the importance of prompt recognition and appropriate volume resuscitation in a pediatric patient suffering from hemorrhagic shock. Emergency medicine physicians should maintain an index of suspicion for Meckel's diverticulum in any pediatric patient presenting with undifferentiated gastrointestinal hemorrhage.Copyright © 2020 Elsevier Inc. All rights reserved.
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