Ileal and Meckel Diverticulum Adenomyomas: Two Pediatric Case Reports and Literature Review

Abstract

Background

Adenomyomas are rare benign lesions of the gastrointestinal tract, mostly found in the biliary tract and stomach. Their occurrence in the small bowel, particularly in children, is exceedingly rare. This report presents two pediatric examples of small bowel adenomyomas, including one within a Meckel diverticulum, a notably rare occurrence.

Case Report 1

An 11-month-old boy presented with intussusception. Surgical exploration revealed a pathologic lead point in the ileum.

Case Report 2

A 12-year-old boy also presented with intussusception. A Meckel diverticulum, acting as a lead point, was identified and excised. Histopathology of both lesions showed cystically dilated glands surrounded by smooth muscle bundles, consistent with adenomyoma, the second within the diverticulum's lesion.

Conclusion

Small bowel adenomyomas, although rare, should be considered in intussusception with a pathological lead point. Both case reports highlight the importance of histopathological examination for diagnosis. This lesion within a Meckel diverticulum represents the fourth pediatric example ever reported, contributing valuable insight into the pathogenesis of this rare entity. Surgical excision remains both diagnostic and curative.