{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T22:31:30Z","timestamp":1783981890809,"version":"3.55.0"},"reference-count":38,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2022,11,24]],"date-time":"2022-11-24T00:00:00Z","timestamp":1669248000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Asymptomatic Meckel\u2019s diverticulum cases are not uncommon, leading to diagnostic difficulties in cases of atypical presentations with only gastrointestinal symptoms other than bloody stool. A nine-year-old boy diagnosed as having cyclic vomiting because of recurrent abdominal pain and vomiting for 6 months was referred to our institute and hospitalized due to worsening symptoms. After admission, abdominal ultrasonography showed the multiple concentric ring sign and a pseudokidney sign at the lower ileum, leading to the diagnosis of ileo-ileal intussusception, but the gastrointestinal symptoms and ultrasonic findings disappeared spontaneously. Transanal, double-balloon, intestinal endoscopy demonstrated a pedunculated polyp-like structure, and surgical resection was performed. An inverted diverticulum was found in the resected intestinal lumen, and ectopic gastric mucosa was identified histologically, leading to the diagnosis of inverted Meckel\u2019s diverticulum. In pediatric cases involving periodic attacks of vomiting and abdominal pain, unnecessary emergent surgery could be avoided by cautious imaging evaluation and consideration of ileo-ileal intussusception with advanced lesions of an inverted Meckel\u2019s diverticulum as a differential diagnosis, without facilely diagnosing cyclic vomiting. In addition, previous reports of inverted Meckel\u2019s diverticulum were reviewed, and the results were compared between adult and pediatric groups in each category.<\/jats:p>","DOI":"10.3390\/children9121817","type":"journal-article","created":{"date-parts":[[2022,11,25]],"date-time":"2022-11-25T02:29:23Z","timestamp":1669343363000},"page":"1817","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["A Pediatric Case of Inverted Meckel\u2019s Diverticulum Presenting with Cyclic Vomiting-like Symptoms: A Case Report and Literature Review"],"prefix":"10.3390","volume":"9","author":[{"given":"Yoshiko","family":"Endo","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo 113-8421, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6317-4305","authenticated-orcid":false,"given":"Keisuke","family":"Jimbo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo 113-8421, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuyasu","family":"Arai","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo 113-8421, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takanori","family":"Ochi","sequence":"additional","affiliation":[{"name":"Department of Pediatric General and Urogenital Surgery, Juntendo University Faculty of Medicine, Tokyo 113-8421, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9969-3454","authenticated-orcid":false,"given":"Mitsuyoshi","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo 113-8421, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsuyuki","family":"Yamataka","sequence":"additional","affiliation":[{"name":"Department of Pediatric General and Urogenital Surgery, Juntendo University Faculty of Medicine, Tokyo 113-8421, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiaki","family":"Shimizu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo 113-8421, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1016\/j.jpedsurg.2011.02.024","article-title":"National trends in the surgical management of Meckel\u2019s diverticulum","volume":"46","author":"Ruscher","year":"2011","journal-title":"J. Pediatr. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Wang, T.Y., Su, Y.T., Ko, P.J., Chen, Y.L., Shih, H.H., and Tsai, C.C. (2022). Chronic nocturnal abdominal pain as the presentation of inverted Meckel diverticulum: A case report. Children, 9.","DOI":"10.3390\/children9010069"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"6155","DOI":"10.3748\/wjg.v18.i42.6155","article-title":"Inverted Meckel\u2019s diverticulum as a cause of occult lower gastrointestinal hemorrhage","volume":"18","author":"Rashid","year":"2012","journal-title":"World J. Gastroenterol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1610","DOI":"10.1016\/j.jpedsurg.2015.05.002","article-title":"Diagnosis and minimally invasive surgical treatment of bleeding Meckel\u2019s diverticulum in children using double-balloon enteroscopy","volume":"50","author":"Qi","year":"2015","journal-title":"J. Pediatr. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e24823","DOI":"10.1097\/MD.0000000000024823","article-title":"The diagnostic and treatment values of double-balloon enteroscopy in children\u2019s Meckel\u2019s diverticular bleeding","volume":"100","author":"Zhu","year":"2021","journal-title":"Medicine"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1016\/j.gie.2008.10.021","article-title":"Double-balloon enteroscopy for bleeding Meckel\u2019s diverticulum in a child younger than 4 years of age","volume":"70","author":"Chen","year":"2009","journal-title":"Gastrointest. Endosc."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1186\/1752-1947-6-328","article-title":"Endoscopic ultrasound with double-balloon endoscopy for the diagnosis of inverted Meckel\u2019s diverticulum: A case report","volume":"6","author":"Araki","year":"2012","journal-title":"J. Med. Case Rep."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e35","DOI":"10.1016\/j.cgh.2012.09.023","article-title":"Successful endoscopic resection of inverted Meckel\u2019s diverticulum by double-balloon enteroscopy","volume":"11","author":"Fukushima","year":"2013","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"86","DOI":"10.4132\/KoreanJPathol.2013.47.1.86","article-title":"Lipoma within inverted Meckel\u2019s diverticulum: A case report","volume":"47","author":"Kim","year":"2013","journal-title":"Korean J. Pathol"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e177","DOI":"10.1016\/j.jemermed.2013.08.071","article-title":"Inverted Meckel\u2019s diverticulum","volume":"46","author":"Ku","year":"2014","journal-title":"J. Emerg. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"281","DOI":"10.2214\/AJR.14.13898","article-title":"CT detection of symptomatic and asymptomatic Meckel diverticulum","volume":"205","author":"Kawamoto","year":"2015","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"rjv112","DOI":"10.1093\/jscr\/rjv112","article-title":"Inverted Meckel\u2019s diverticulum causing intussusception in a Crohn\u2019s patient","volume":"9","author":"Sharp","year":"2015","journal-title":"J. Surg. Case Rep."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e171","DOI":"10.14309\/crj.2016.144","article-title":"Inverted Meckel\u2019s diverticulum with intussusception and ulceration diagnosed after rectal double-balloon enteroscopy","volume":"3","author":"Halloran","year":"2016","journal-title":"ACG Case Rep. J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1016\/j.clinimag.2016.03.009","article-title":"Inverted Meckel diverticulum as a lead point of small bowel intussusception: Misinterpreting case as a lipoma","volume":"40","author":"Kim","year":"2016","journal-title":"Clin. Imag."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"4416","DOI":"10.3748\/wjg.v22.i17.4416","article-title":"Inverted Meckel\u2019s diverticulum preoperatively diagnosed using double-balloon enteroscopy","volume":"22","author":"Takagaki","year":"2016","journal-title":"World J. Gastroenterol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1159\/000481161","article-title":"Intussusception due to an inverted Meckel\u2019s diverticulum diagnosed by double-balloon enteroscopy","volume":"11","author":"Kawasaki","year":"2017","journal-title":"Case Rep. Gastroenterol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e66","DOI":"10.1055\/s-0042-121008","article-title":"Endoscopic full-thickness resection for inverted Meckel\u2019s diverticulum using double-balloon enteroscopy","volume":"49","author":"Konomatsu","year":"2017","journal-title":"Endoscopy"},{"key":"ref_18","first-page":"399","article-title":"Inverted Meckel\u2019s diverticulum: A rare cause of ileo-ileal intussusceptions and lower gastrointestinal bleeding","volume":"97","author":"Matek","year":"2018","journal-title":"Rozhl. Chir."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"70","DOI":"10.4240\/wjgs.v10.i6.70","article-title":"Inverted Meckel\u2019s diverticulum: Two case reports and a review of the literature","volume":"10","author":"Chong","year":"2018","journal-title":"World J. Gastrointest. Surg."},{"key":"ref_20","first-page":"3241782","article-title":"Small bowel obstruction secondary to intussuscepted Meckel\u2019s diverticulum in an adult","volume":"2019","author":"Marascia","year":"2019","journal-title":"Case Rep. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"rjz367","DOI":"10.1093\/jscr\/rjz367","article-title":"Ileectomy performed on a case of adult intussusception due to inversion of Meckel\u2019s diverticulum","volume":"2020","author":"Abe","year":"2020","journal-title":"J. Surg. Case Rep."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1186\/s40792-020-01061-y","article-title":"Intussusception caused by a small intestinal lipoma with ectopic gastric mucosa containing gastric cystica profunda component cells within the inverted Meckel\u2019s diverticulum: A case report","volume":"6","author":"Yamauchi","year":"2020","journal-title":"Surg. Case Rep."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1186\/s13256-021-02736-2","article-title":"Inverted Meckel\u2019s diverticulum: A case report","volume":"15","author":"Bains","year":"2021","journal-title":"J. Med. Case Rep."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1118","DOI":"10.1016\/j.radcr.2021.02.025","article-title":"A case report of inverted Meckel\u2019s diverticulum","volume":"16","author":"Rhodes","year":"2021","journal-title":"Radiol. Case Rep."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"6154","DOI":"10.3748\/wjg.v27.i36.6154","article-title":"Inverted Meckel\u2019s diverticulum diagnosed using capsule endoscopy: A case report","volume":"27","author":"Calvo","year":"2021","journal-title":"World J. Gastroenterol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1097\/00004728-199603000-00022","article-title":"Inverted Meckel diverticulum with intussusception: Demonstration by CT","volume":"20","author":"Hamada","year":"1996","journal-title":"J. Comput. Assist. Tomogr."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"688","DOI":"10.1007\/s00261-005-8010-2","article-title":"Pancreatic pseudotumor in Meckel diverticulum","volume":"31","author":"Monedero","year":"2006","journal-title":"Abdom. Imaging"},{"key":"ref_28","first-page":"308","article-title":"Ileoileal intussusception due to an inverted Meckel\u2019s diverticulum in a child","volume":"70","author":"Alexiou","year":"2007","journal-title":"Acta Gastroenterol. Belg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1002\/jcu.20681","article-title":"An unusual cause of acute abdominal pain in a child: An inverted Meckel diverticulum: Report of a case","volume":"38","author":"Yigiter","year":"2010","journal-title":"J. Clin. Ultrasound"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.ijscr.2011.10.008","article-title":"Acute appendicitis with unusual dual pathology","volume":"3","author":"Riddiough","year":"2012","journal-title":"Int J. Surg. Case Rep."},{"key":"ref_31","first-page":"6","article-title":"Inverted Meckel\u2019s diverticulum simulating pedunculated polyp as a lead point for ileoileal intussusception in a child","volume":"4","author":"Mirza","year":"2013","journal-title":"APSP J. Case Rep."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"789","DOI":"10.4103\/ijccm.IJCCM_317_17","article-title":"Meckel\u2019s diverticulitis masquerading as acute pancreatitis: A diagnostic dilemma","volume":"21","author":"Darlington","year":"2017","journal-title":"Indian J. Crit Care Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e12154","DOI":"10.1097\/MD.0000000000012154","article-title":"Systematic review of epidemiology, presentation, and management of Meckel\u2019s diverticulum in the 21st century","volume":"97","author":"Hansen","year":"2018","journal-title":"Medicine"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1002\/ca.21094","article-title":"Meckel\u2019s diverticulum: A review","volume":"24","author":"Uppal","year":"2011","journal-title":"Clin. Anat."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"267","DOI":"10.3389\/fped.2019.00267","article-title":"Symptomatic Meckel\u2019s Diverticulum in pediatric patients-case reports and systematic review of the literature","volume":"7","author":"Keese","year":"2019","journal-title":"Front. Pediatr."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"275","DOI":"10.2214\/AJR.05.2049","article-title":"Sonography of pediatric small-bowel intussusception: Differentiating surgical from nonsurgical cases","volume":"188","author":"Munden","year":"2007","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"948","DOI":"10.1111\/j.1442-200X.2012.03622_1.x","article-title":"Japanese guidelines for the management of intussusception in children, 2011","volume":"54","author":"Ito","year":"2012","journal-title":"Pediatr. Int."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1097\/MPG.0000000000002813","article-title":"Endoscopic Removal of a Single, Painless, Juvenile Polyp in the Small Intestine Causing Anemia","volume":"71","author":"Krasaelap","year":"2020","journal-title":"J. Pediatr. Gastroenterol. Nutr."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/9\/12\/1817\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:26:21Z","timestamp":1760145981000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/9\/12\/1817"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,24]]},"references-count":38,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["children9121817"],"URL":"https:\/\/doi.org\/10.3390\/children9121817","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,24]]}}}