Čes-slov Pediat 2026, 81(5):284-287 | DOI: 10.55095/CSPediatrie2026/037

Meckel's diverticulum and fibrous residual omphaloenteric duct with ectopic endocrine pancreatic tissue as a cause of ileus

Jiří Slavíček¹, Jakub Fichtl¹, Ondřej Daum², Jiří Moláček¹

¹ Chirurgická klinika, Lékařská fakulta, Univerzita Karlova a Fakultní nemocnice Plzeň

² Šiklův ústav patologie, Lékařská fakulta, Univerzita Karlova a Fakultní nemocnice Plzeň

Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract. The incidence ranges between 1-3 %. Only approximately 4 % of cases manifest clinically, and only rarely as an acute abdomen

requiring surgical intervention. A symptomatic diverticulum occurs more frequently in male population and most commonly presents as gastrointestinal bleeding. Up to 50 % of Meckel's diverticulum contain heterotopic mucosa originating in the pancreas or stomach.

In this case report we present a 5-year-old boy with a history of abdominal pain lasting several hours and a diagnosis of small bowel ileus. An acute laparotomy was performed with the finding a Meckel's diverticulum, which continued as a fibrous remnant to the umbilicus and caused

strangulation of a small bowel loop. The histological finding was surprising, where in addition to heterotopia of oxyntic gastric mucosa, endocrine pancreatic tissue was identified in the fibrous remnant outside the diverticulum itself.

Keywords: Meckel's diverticulum, congenital gastrointestinal tract anomaly, ileus, acute abdomen, strangulation, endocrine pancreatic tissue, omphalomesenteric duct

Received: March 20, 2026; Revised: June 5, 2026; Accepted: June 8, 2026; Published: July 1, 2026  Show citation