2017 Volume 59 Issue 9 Pages 2416-2421
A 27-year-old man with melena visited a local physician. Bleeding scintigraphy showed a hot spot in the distal ileum, and he was referred to our hospital to inspect the small intestine in more detail. First, we performed 99mTc-scintigraphy ; however, there was no positive signal of Meckel’s diverticulum. Then, double-balloon endoscopy revealed a pedunculated polyp that was similar to an upheaval lesion of approximately 50mm in size with an ulcer on the top. The polyp was located 40cm on the oral side from Bauhin’s valve. Although we had planned to resect this polyp endoscopically, histological examination of biopsy specimens from the top of the polyp revealed ectopic gastric mucosa. Therefore, the diagnosis was changed from an ileal polyp to inverted Meckel’s diverticulum, and laparoscopic ileal segmental resection was performed. The resected specimen exhibited an ectopic gastric gland and pancreatic tissue. Endoscopic resection of inverted Meckel’s diverticulum is associated with complications such as gastrointestinal perforation and should be avoided. It is important to be able to recognize the characteristic endoscopic image of inverted Meckel’s diverticulum.
