{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T15:05:15Z","timestamp":1785769515079,"version":"3.56.0"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T00:00:00Z","timestamp":1755475200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Meckel's diverticulum (MD), a congenital anomaly of the gastrointestinal tract, affects approximately 2 % of the population, but complications occur in only 4\u20136 % of cases. Symptomatic MD is typically seen in children, with adult presentations being rare and often incidental. Umbilical complications related to persistent vitelline duct remnants are extremely uncommon in adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation:<\/jats:title>\n                    <jats:p>A 21-year-old-male without previous abdominal symptoms presented with a two-year history of dull periumbilical pain, gradually progressing to purulent umbilical discharge, low-grade fever, a small sinus opening, and granulomatous tissue. Laboratory investigations including CBC, CRP, and liver\/renal panels were normal. Ultrasound revealed a hypoechoic tract from the umbilicus to the pelvis, suggestive of an infected urachal remnant. Exploratory laparotomy revealed a 2-inch inflamed Meckel's diverticulum located 65 cm from the ileocecal valve, connected to the umbilicus by a fibrous tract. Diverticulectomy, excision of the tract and granuloma, and umbilicoplasty were performed. Histopathology confirmed MD with chronic inflammation and no ectopic mucosa. The postoperative course was uneventful.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>This case illustrates a rare adult complication of MD presenting as an umbilical sinus with granulomatous changes, mimicking a urachal anomaly. While adult MD typically presents with bleeding, obstruction, or inflammation, umbilical fistulation is rarely reported in adults. Early surgical exploration was essential for accurate diagnosis and treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Infected MD with umbilical perforation and granulomatous tissue is exceptionally rare in adults. It should be considered in the differential diagnosis of persistent umbilical discharge. Surgical exploration can provide definitive diagnosis and curative treatment, particularly in resource-limited settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2025.111841","type":"journal-article","created":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T16:55:43Z","timestamp":1755622543000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Unusual presentation of an infected Meckel's diverticulum with umbilical perforation and granulomatous lesion in a young Adult: A rare case report from a resource-constrained setting"],"prefix":"10.1097","volume":"135","author":[{"given":"Mathayo","family":"Shadrack","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Telesphory Tryphone","family":"Kyaruzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scholastica Joseph","family":"Mulima","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Muhimbili National Hospital (MNH), P.O. Box 65000, Dar es salaam, Tanzania."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Godfrey","family":"Mbunda","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Muhimbili National Hospital (MNH), P.O. Box 65000, Dar es salaam, Tanzania."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim","family":"Mkoma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zaituni","family":"Bokhary","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"issue":"2","key":"R1-40-20260803","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1016\/0002-9610(78)90238-6","article-title":"Meckel's diverticulum: investigation of 600 patients in Japanese literature","volume":"136","author":"Yamaguchi","year":"1978","journal-title":"Am. J. 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Engl"},{"key":"R9-40-20260803","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2013-203330","article-title":"Diverticulotransverse colonic fistula secondary to Meckel's diverticulum","author":"Lo","year":"2015","journal-title":"BMJ Case Rep"},{"issue":"9","key":"R10-40-20260803","first-page":"2235","article-title":"Diagnostic accuracy of CT scan in complicated Meckel's diverticulum","volume":"34","author":"Suri","year":"2010","journal-title":"World J. Surg"},{"key":"R12-40-20260803","article-title":"Perforated Meckel's diverticulum in an adult: case report and literature review","volume":"124","author":"Chaves","year":"2024","journal-title":"Int. J. Surg. Case Rep"},{"key":"R13-40-20260803","article-title":"Revised surgical CAse REport (SCARE) guideline: an update for the age of artificial intelligence","volume":"10","author":"Kerwan","year":"2025","journal-title":"Premier J. 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