The common clinical manifestations of Meckel’s diverticulum include painless lower gastrointestinal bleeding and intestinal obstruction due to intussusception. Intussusception induced by inverted Meckel’s diverticulum has rarely been reported; furthermore, there is no report thus far of chronic nocturnal abdominal pain as a presenting symptom in children with Meckel’s diverticulum. A 4-year-and-10-month-old girl with no significant history of previous illness presented with the sole complaint of chronic nocturnal abdominal pain for 3 months. The patient was reported to be asymptomatic during the day. A provisional diagnosis of chronic ileoileal intussusception was already under consideration in her previous hospital visits elsewhere. Physical examination revealed a soft, non-distended abdomen without tenderness. Imaging studies revealed ileoileal intussusception. Exploratory laparotomy showed ileoileal intussusception induced by an inverted Meckel’s diverticulum with ulceration. The patient underwent successful surgery and made a full recovery. We report this case to remind physicians that Meckel’s diverticulum should be considered in differential diagnosis of children presenting with the isolated symptom of chronic nocturnal abdominal pain.

Anorectal necrosis is an uncommon lethal disease in children, characterized by necrosis of the mucosa of the anus and rectum. The difference between anorectal necrosis and Fournier’s gangrene is that anorectal necrosis does not affect the genital organs. The treatment for anorectal necrosis includes debridement of the anus, colostomy, and the use of broad-spectrum antibiotics. However, anorectal necrosis may lead to anal stricture, anal malfunction, or even acquired atresia of the anus. There is no consensus on the treatment for acquired imperforate anus. Herein, we report a case of a four-month-old boy with acquired imperforate anus complicated by anorectal necrosis. We describe our experience performing posterior sagittal anorectoplasty to reconstruct a neo-anus in such a rare case.