Double Trouble: a Rare Case of Small Bowel Intussusception Secondary to Neuroendocrine Tumour Within a Meckel’s Diverticulum

Meckel’s diverticulum (MD) is a congenital abnormality of the gastrointestinal tract occurring in 2% of the general population, and is rarely symptomatic. MD can present with gastrointestinal bleeding, perforation, bowel obstruction or intussusception. We present a rare case of a 16-year-old male who presented with small bowel intussusception. The patient required an emergency laparotomy with small bowel resection. He recovered well and was discharged 5 days postoperatively. The histopathology revealed ulcerated Meckel’s diverticulum with well-differentiated neuroendocrine tumour (grade 1), without any lymphovascular invasion. There were no lymph nodes seen in the mesentery. His pathology was discussed at the gastrointestinal multi-disciplinary team meeting. The recommendation was to follow up 6 monthly with urinary 5HIAA and serum CgA, with consideration for colonoscopy when the patient turns 18 years old. Neuroendocrine tumours (NETs) remain a rare finding within MD with a reported incidence of 2.1% following Meckel’s diverticulectomy. These tumours are rarely symptomatic and often present at advanced stage. While emerging research suggests that radical oncological resection of NETs in adults is recommended regardless of tumour size, level of invasion, or differentiation to prevent regional and distant spread, limited consensus is available on management of NETs in children.