Intestinal hemorrhage caused by Meckel’s diverticulum with ectopic gastric mucosa on polypoid lesion: a case report

Meckel’s diverticulum is a congenital diverticulum. Mostly it is asymptomatic. In children the commonest complication is lower GI bleeding. High index of suspicion is required for its diagnosis. Technetium-99m pertechnetate scan is useful to detect ectopic gastric mucosa. Surgical treatment of symptomatic Meckel’s diverticulum is diverticulectomy or ileal resection.DOI: http://dx.doi.org/10.3126/jnps.v34i1.9523J Nepal Paediatr Soc 2014;34(1):54-56

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Meckel’s diverticulum with intraperitoneal hemorrhage in a child detected with screening laparoscopy: a case report

Surgical Case Reports ◽

10.1186/s40792-021-01347-9 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Kazuki Wakizaka ◽

Lee Wee Khor ◽

Kazuya Annen ◽

Tsuyoshi Fukushima ◽

Mitsuko Furuya ◽

...

Keyword(s):

Abdominal Pain ◽

Gastric Mucosa ◽

Meckel’S Diverticulum ◽

Lower Abdominal Pain ◽

Abdominal Distension ◽

Small Bowel Resection ◽

Massive Bleeding ◽

Meckel's Diverticulum ◽

Ectopic Gastric Mucosa ◽

Intraperitoneal Hemorrhage

Abstract Background The most common presentation of symptomatic Meckel’s diverticulum (MD) are intestinal obstruction, gastrointestinal hemorrhage, and inflammation of the MD with or without perforation. Intraperitoneal hemorrhage because of MD is extremely rare. We report a case of MD with intraperitoneal hemorrhage in a child detected with screening laparoscopy. Case presentation An 11-year-old girl presented to another hospital with lower abdominal pain and vomiting that lasted for 2 days. Acute appendicitis was suspected, and she was referred to our department. Abdominal enhanced computed tomography showed an abscess in the lower abdomen with ascites in the pelvis. She was diagnosed with a localized intra-abdominal abscess and the decision was made to treat with antibiotics. However, her abdominal pain worsened, with abdominal distension, tenderness and guarding. She was diagnosed with panperitonitis and the decision was made for surgery 5 h after admission. During surgery, laparoscopic observation from the umbilical region revealed 200 ml of fresh blood throughout the peritoneal cavity, originating from the mesentery of the ileum. MD was observed with bleeding from the surrounding mesentery. Small bowel resection was performed, and the patient was discharged on the 5th postoperative day. Pathological findings revealed an MD containing ectopic gastric mucosa and small intestinal ulcer perforation at the base of the MD. Conclusions We report an extremely rare case of an MD with intraperitoneal hemorrhage in a child. In pediatric cases, it is possible that perforation with ectopic gastric mucosa may cause massive bleeding because of rupture of the surrounding mesenteric blood vessels.

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Helicobacter pylori in ectopic gastric mucosa in Meckel's diverticulum

Pathology ◽

10.1080/00313029800169585 ◽

1998 ◽

Vol 30 (1) ◽

pp. 7-9 ◽

Cited By ~ 18

Author(s):

Prudence Hill ◽

Jurgen Rode

Keyword(s):

Helicobacter Pylori ◽

Gastric Mucosa ◽

Meckel’S Diverticulum ◽

Meckel's Diverticulum ◽

Ectopic Gastric Mucosa

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Specific characteristics of hemorrhagic Meckel’s diverticulum at double-balloon endoscopy

Endoscopy International Open ◽

10.1055/s-0042-119810 ◽

2017 ◽

Vol 05 (01) ◽

pp. E35-E40

Author(s):

Yasuyuki Mizutani ◽

Masanao Nakamura ◽

Osamu Watanabe ◽

Takeshi Yamamura ◽

Kohei Funasaka ◽

...

Keyword(s):

Gastric Mucosa ◽

Gastrointestinal Bleeding ◽

Medical Records ◽

Meckel’S Diverticulum ◽

Meckel's Diverticulum ◽

Ectopic Gastric Mucosa ◽

Diagnostic Ability ◽

Double Balloon Endoscopy ◽

Double Balloon

Abstract Background and study aims Diagnosis of Meckel’s diverticulum (MD) before surgery may be challenging; double-balloon endoscopy (DBE) facilitates identification of MD in the setting of a gastrointestinal bleeding; however, MD can be found incidentally without this condition. The purpose of this research was to determine specific characteristic of hemorrhagic MD and incidental MD at DBE. Patients and methods Ectopic gastric mucosa enclosed in the MD and/or ulceration were defined as “major findings”; ring-like scar surrounding the MD was defined as “minor finding”. We retrospectively reviewed the medical records of patients affected by MD and analyzed the findings that significantly affected the characterization of MD. Results MD was diagnosed in 33 patients. The axis of the diverticulum was longer in hemorrhagic MD compared to incidental MD (P = 0.031). The amount of transfusion was significantly higher (P = 0.018) in the hemorrhagic MD group. Hemorrhagic MD was significantly more correlated with major findings (P = 0.01) and minor findings (P < 0.01). The specificity of major finding was 100 % while the sensitivity of major and/or minor findings was 96 %. Conclusions The combination of major and minor findings appears to improve the diagnostic ability of hemorrhagic MD avoiding unnecessary diverticulectomy.

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Meckel's Diverticulum with Intussusception, Ulceration with Hemorrhage, and Ectopic Gastric Mucosa And Pancreatic Tissue

Gastroenterology ◽

10.1016/s0016-5085(53)80009-0 ◽

1953 ◽

Vol 24 (2) ◽

pp. 222-231 ◽

Cited By ~ 1

Author(s):

Michael F. Koszalka

Keyword(s):

Gastric Mucosa ◽

Meckel’S Diverticulum ◽

Pancreatic Tissue ◽

Meckel's Diverticulum ◽

Ectopic Gastric Mucosa

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Meckel’s Diverticulum: Factors Associated with Clinical Manifestations

ISRN Gastroenterology ◽

10.1155/2014/390869 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5 ◽

Cited By ~ 7

Author(s):

Jeng-Jung Chen ◽

Hung-Chang Lee ◽

Chun-Yan Yeung ◽

Wai-Tao Chan ◽

Chuen-Bin Jiang ◽

...

Keyword(s):

Clinical Features ◽

Pediatric Patients ◽

Meckel’S Diverticulum ◽

Age Groups ◽

Clinical Manifestations ◽

Meckel's Diverticulum ◽

Adult Patients ◽

Ectopic Gastric Mucosa ◽

Intestinal Hemorrhage ◽

Clinical Presentations

Objectives. The purpose of this study was to investigate the clinical features of Meckel’s diverticula at different ages, genders, and pathology in order to serve as a reminder to clinicians when evaluating potential cases and to help obtain an early diagnosis. Methods. We collected information of patients with Meckel’s diverticulum diagnosed at Mackay Memorial Hospital in Taiwan from 1984 to 2009. After performing a thorough review of their charts, the clinical features of the Meckel’s diverticula were analyzed according to age groups, gender, and pathology. Result. A total of 126 patients, with 90 males and 36 females, were enrolled in this study. Seventy-five patients were symptomatic and 51 Meckel’s diverticula were found incidentally during surgery for other diseases. Among symptomatic patients, 39% of pediatric patients and 5% of adult patients had intestinal hemorrhage. Twenty-eight percent of pediatric patients and 67% of adult patients had inflammation of Meckel’s diverticulum. Forty-six percent of males and 16% of females had inflammation. Conversely, 27% of males and 58% percent of females had intestinal obstruction. When Meckel’s diverticulum had ectopic gastric mucosa, it tended to cause intestinal hemorrhage when the patient is young. Conclusions. Age, gender, and pathology affect the clinical presentations of Meckel’s diverticula.

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Technetium Pertechnetate Scintigraphy to Detect Ectopic Gastric Mucosa in Meckel's Diverticulum

Acta Radiologica Diagnosis ◽

10.1177/028418518402500513 ◽

1984 ◽

Vol 25 (5) ◽

pp. 417-422 ◽

Cited By ~ 21

Author(s):

M. Fries ◽

W. Mortensson ◽

B. Robertson

Keyword(s):

Gastric Mucosa ◽

Diagnostic Accuracy ◽

Rectal Bleeding ◽

Meckel’S Diverticulum ◽

Meckel's Diverticulum ◽

Infants And Children ◽

Histologic Examination ◽

Ectopic Gastric Mucosa ◽

Consistent Finding ◽

Predominant Symptom

Tc-pertechnetate scintigraphy was performed in 81 infants and children, clinically suspected to have Meckel's diverticulum with ectopic gastric mucosa. The predominant symptom was rectal bleeding and anemia. Twenty-two patients underwent laparotomy and 12 had Meckel's diverticulum with ectopic gastric mucosa. In operated patients the sensitivity of scintigraphy in detecting ectopic gastric mucosa was 0.75, the specificity 1.0 and the diagnostic accuracy 0.86; the diagnostic accuracy was estimated to 0.96 for the whole material. Histologic examination of the diverticula showed a smaller area of the ectopic mucosa in cases with negative scintigraphic findings. In addition, prominent fibrosis seemed to be a more consistent finding in cases with negative as opposed to those with positive scintigraphic findings. Presence of anemia may provide a guideline as to whether or not scintigraphy is indicated.

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