Meckel’s diverticulum: a cause of recurrent gastrointestinal bleeding
https://doi.org/10.35401/2541-9897-2023-26-2-100-102
Abstract
Background: Obscure gastrointestinal bleedings accounting for 5%-30% of all gastrointestinal bleedings continue to be a challenge and usually originate from the small bowel.
Clinical case: We present a case of a female patient hospitalized with signs of gastrointestinal bleeding three times within 3 months. We could not identify the source of bleeding using standard methods, such as abdominal computed tomography and ultrasonography, esophagogastroduodenoscopy, and colonoscopy. We detected a Meckel’s diverticulum during a diagnostic laparoscopy and performed wedge resection of the small bowel. Histopathology results revealed an acute progressive ulcer in the wall of the small bowel diverticulum.
Conclusions: Diagnostic laparoscopy is one of the available minimally invasive procedures, which in some cases can successfully identify the source of small bowel bleeding.
About the Authors
V. V. Polovinkin
Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1; Kuban State Medical University
Russian Federation
Russian Federation
Vadim V. Polovinkin, Dr. Sci. (Med.), Head of the Coloproctology Unit; Head of the General Surgery Department
ulitsa 1 Maya 167, Krasnodar, 350086, Russian Federation
S. V. Khmelik
Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1
Russian Federation
Russian Federation
Sergey V. Khmelik, Coloproctologist, Coloproctology Unit
Krasnodar
Liu Zheng
Chinese Academy of Medical Sciences and Peking Union Medical College
China
China
Zheng Liu, MD, PhD, Professor, Department of Colorectal Surgery, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital
Beijing
References
1. ASGE Standards of Practice Committee, Fisher L, Lee Krinsky M, et al. The role of endoscopy in the management of obscure GI bleeding. Gastrointest Endosc. 2010;72(3):471–479. PMID: 20801285. https://doi.org/10.1016/j.gie.2010.04.032
2. ASGE Standards of Practice Committee, Gurudu SR, Bruining DH, et al. The role of endoscopy in the management of suspected small-bowel bleeding. Gastrointest Endosc. 2017;85(1):22–31. PMID: 27374798. https://doi.org/10.1016/j.gie.2016.06.013
3. Pennazio M, Eisen G, Goldfarb N; ICCE. ICCE consensus for obscure gastrointestinal bleeding. Endoscopy. 2005;37(10):1046–1050. PMID: 16189788. https://doi.org/10.1055/s-2005-870319
4. Lewis BS. Enteroscopy. Gastrointest Endosc Clin N Am. 2000;10(1):101–vii. PMID: 10618457.
5. Vorobeĭ AV, Klimovich VV, Karpovich DI, Zhura AV, Nekrasov DA. Gastrointestinal bleedings of non-ulcer etiology. Khirurgiia (Mosk). 2009;(10):20–23. (In Russ.). PMID: 20032931.
6. Zuckerman GR, Prakash C, Askin MP, Lewis BS. AGA technical review on the evaluation and management of occult and obscure gastrointestinal bleeding. Gastroenterology. 2000;118(1):201–221. PMID: 10611170. https://doi.org/10.1016/s0016-5085(00)70430-6
7. Koulaouzidis A, Giannakou A, Yung DE, Dabos KJ, Plevris JN. Do prokinetics influence the completion rate in small-bowel capsule endoscopy? A systematic review and meta-analysis. Curr Med Res Opin. 2013;29(9):1171–1185. PMID: 23790243. https://doi.org/10.1185/03007995.2013.818532
8. Liao Z, Gao R, Xu C, Li ZS. Indications and detection, completion, and retention rates of small-bowel capsule endoscopy: a systematic review. Gastrointest Endosc. 2010;71(2):280–286. PMID: 20152309. https://doi.org/10.1016/j.gie.2009.09.031
9. Ell C, May A, Nachbar L, et al. Push-and-pull enteroscopy in the small bowel using the double-balloon technique: results of a prospective European multicenter study. Endoscopy. 2005;37(7):613–616. PMID: 16010603. https://doi.org/10.1055/s-2005-870126
Review
For citations:
Polovinkin V.V., Khmelik S.V., Zheng L. Meckel’s diverticulum: a cause of recurrent gastrointestinal bleeding. Innovative Medicine of Kuban. 2023;(2):100-102. (In Russ.) https://doi.org/10.35401/2541-9897-2023-26-2-100-102
Views:
346
Email this article 
