A Case of Intussusception Due to an Inverted Meckel’s Diverticulum With Bleeding From the Meckel’s Diverticulum

Abstract

An 8-year-old girl presented with anorexia and vomiting. Although her symptoms improved temporarily, she presented again with copious bloody stools and pallor and was taken to the emergency room. Her abdomen was flat and soft without tenderness. Ultrasonography revealed intussusception of the small intestine with a mass of 15 mm diameter at the leading part. Contrast-enhanced computed tomography showed no mass, and contrast was preserved in the intestinal tract. Emergency laparoscopic-assisted laparotomy was performed on that same day. A small bowel intussusception with a mass lesion was found in the small intestine 110 cm orally from the terminal ileum. The small intestine including the mass lesion was partially resected through the elongated umbilical incision. A pathological examination revealed an internally displaced hemorrhagic Meckel’s diverticulum. An inverted Meckel’s diverticulum is often found at the leading site of intestinal intussusception. The unique aspect of this case was the presentation of copious bloody stools, which could not be explained by intussusception alone, and was probably caused by bleeding from the ulcer bed in Meckel’s diverticulum. It is important to suspect intussusception caused by an inverted Meckel’s diverticulum with bleeding from the ulcer bed in patients who have copious bloody stools and a mass lesion at the leading site.