Double whammy: Acute suppurative appendicitis on top of Meckel's diverticulum.

Meckel's diverticulum (MD), a congenital abnormality occurring in 0.3% to 3% of individuals, shares overlapping clinical features with acute appendicitis (AA), a common surgical emergency, making simultaneous presentation diagnostically challenging. An 11-year-old boy presented with right lower abdominal pain, fever, and loss of appetite, exhibiting positive Rovsing and Psoas signs. Elevated inflammatory markers and ultrasound findings suggested acute appendicitis with concurrent Meckel's diverticulitis. Surgery confirmed acute suppurative appendicitis and an inflamed MD, both of which were successfully treated with appendectomy and segmental intestinal resection. The patient had an uneventful recovery and remained well during follow-up. This case highlights the importance of considering MD in pediatric abdominal pain and performing thorough intraoperative assessments to ensure accurate diagnosis and effective treatment.