{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T08:56:55Z","timestamp":1791449815395,"version":"4.3.3"},"reference-count":8,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"vor","delay-in-days":280,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Surgery"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>Meckel\u2019s diverticulum is the most common congenital anomaly of the gastrointestinal tract but remains diagnostically challenging in children because of its varied and nonspecific clinical presentation. Concomitant Meckel\u2019s diverticulum and acute appendicitis are uncommon and may further obscure diagnosis. We report a 9\u2010year\u2010old boy who presented with chronic periumbilical abdominal pain of 3 months\u2019 duration, with acute worsening over 3 days accompanied by vomiting. Physical examination revealed localized right periumbilical tenderness without signs of peritonitis. Laboratory investigations demonstrated mild anemia and eosinophilia, while ultrasonography identified an appendicolith with mesenteric lymphadenitis, raising suspicion for appendiceal pathology. Owing to persistent symptoms and concern for evolving subacute intestinal obstruction, diagnostic laparoscopy was performed. Intraoperatively, acute appendicitis was identified along with a dilated Meckel\u2019s diverticulum ~100\u2009cm proximal to the ileocecal junction and associated proximal small\u2010bowel dilatation. Laparoscopic\u2010assisted Meckel\u2019s diverticulectomy with appendectomy was successfully performed. Histopathologic examination confirmed acute appendicitis with a fecolith and transmural inflammatory infiltrates. The Meckel\u2019s diverticulum demonstrated focal Paneth cell metaplasia and lymphoid aggregates consistent with Peyer patches without ectopic gastric or pancreatic tissue or atypia. The mesenteric lymph node showed reactive lymphoid hyperplasia. The postoperative course was uneventful, and the child remained symptom\u2010free at 2\u2010month follow\u2010up. This case highlights the importance of considering dual intraabdominal pathology in children presenting with prolonged or atypical abdominal pain. Diagnostic laparoscopy plays a pivotal role by enabling comprehensive abdominal evaluation and definitive treatment in a single setting. Furthermore, symptomatic Meckel\u2019s diverticulum may occur in the absence of heterotopic mucosa, and uncommon histopathologic findings such as focal Paneth cell metaplasia underscore the value of meticulous examination of resected specimens.<\/jats:p>","DOI":"10.1155\/cris\/8396874","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T08:40:42Z","timestamp":1791448842000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Concomitant Meckel\u2019s Diverticulum With Focal Paneth Cell Metaplasia and Acute Appendicitis Presenting as Chronic Periumbilical Pain in a Child"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-5470-7721","authenticated-orcid":false,"given":"Aditya","family":"Pachwa","sequence":"first","affiliation":[{"name":"Mamata Academy of Medical Sciences  Hyderabad 500118 India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaitanya Laasya Reddy","family":"Arimanda","sequence":"additional","affiliation":[{"name":"Malla Reddy Institute of Medical Sciences  Hyderabad 500118 India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agasthya","family":"Daggu","sequence":"additional","affiliation":[{"name":"Mamata Academy of Medical Sciences  Hyderabad 500055 India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6635-5226","authenticated-orcid":false,"given":"Lakshya Nehal","family":"Samineni","sequence":"additional","affiliation":[{"name":"College of Medical Sciences Teaching Hospital  Chitwan Bharatpur 44200 Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,8]]},"reference":[{"key":"e_1_2_11_1_2","doi-asserted-by":"publisher","DOI":"10.1177\/014107680609901011"},{"key":"e_1_2_11_2_2","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2019.00267"},{"key":"e_1_2_11_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12893-024-02323-4"},{"key":"e_1_2_11_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2004.11.032"},{"key":"e_1_2_11_5_2","doi-asserted-by":"publisher","DOI":"10.4293\/JSLS.2014.00015"},{"key":"e_1_2_11_6_2","doi-asserted-by":"publisher","DOI":"10.12998\/wjcc.v12.i4.865"},{"key":"e_1_2_11_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2005.068601"},{"key":"e_1_2_11_8_2","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2020.00280"}],"container-title":["Case Reports in Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/cris\/8396874","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/cris\/8396874","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/cris\/8396874","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T08:40:43Z","timestamp":1791448843000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/cris\/8396874"}},"subtitle":[],"editor":[{"given":"Andee Dzulkarnaen","family":"Zakaria","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":8,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/cris\/8396874"],"URL":"https:\/\/doi.org\/10.1155\/cris\/8396874","archive":["Portico"],"relation":{},"ISSN":["2090-6900","2090-6919"],"issn-type":[{"value":"2090-6900","type":"print"},{"value":"2090-6919","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2026-08-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"8396874"}}