Neonatal Perforated Meckel’s Diverticulum: A Systematic Review of 62 Published Cases
DOI:
https://doi.org/10.63682/jns.v15i1s.10086Keywords:
Meckel’s diverticulum, Neonatal intestinal perforation, Pneumoperitoneum, Necrotizing enterocolitis, Neonate, Systematic reviewAbstract
Background:Perforated Meckel’s diverticulum (MD) in neonates is a rare but potentially life-threatening surgical emergency. Its clinical and radiological presentation often mimics necrotizing enterocolitis (NEC), leading to delayed recognition. Available evidence is limited to isolated case reports.
Methods:A systematic review was conducted in accordance with PRISMA 2020 principles. PubMed, Scopus, and Google Scholar were searched from database inception to 15 December 2025 for neonates (≤28 days) with surgically confirmed perforated MD. Data on demographics, presentation, operative findings, histopathology, and outcomes were extracted. Given the heterogeneity and case-report level evidence, findings were synthesised descriptively. No meta-analysis was performed due to heterogeneity and case-report level evidence.
Results:Sixty-two cases were identified. Most infants were term (76%) and presented within the first week of life (median 3 days). Abdominal distension (85%), bilious vomiting (65%), and pneumoperitoneum (73%) were common. NEC was the most frequent preoperative diagnosis. Segmental ileal resection was performed in 77% of cases, while diverticulectomy was undertaken in 23%. Ectopic mucosa was absent in 69%. Mortality (11%) occurred exclusively in premature neonates with significant systemic comorbidities.
Conclusion:Neonatal perforated MD frequently mimics NEC. Outcomes appear more closely related to prematurity and systemic illness than operative strategy. In neonates with unexplained perforation or atypical NEC, early surgical exploration with careful inspection of the distal ileum is essential.
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