Meckel's diverticulum detected by virtual enteroscopy in a patient with nonsteroidal anti-inflammatory drug-induced enteropathy

Abstract

A 68-year-old female presented to our hospital with abdominal discomfort and obscure gastrointestinal bleeding. She had been prescribed aspirin for retinal venous occlusion. Video capsule endoscopy (VCE) revealed multiple erosions, annular ulcers, and bleeding, confirming a diagnosis of nonsteroidal anti-inflammatory drug (NSAID)-induced enteropathy. Virtual enteroscopy (VE) was performed to evaluate stenosis of the small intestine, during which a 5-cm long diverticulum was incidentally detected at a site 99cm from the ileocecal valve. On the basis of the location, size, and shape, a diagnosis of Meckel's diverticulum was made. Second look of the VCE images could not detect the Meckel's diverticulum. After the cessation of taking aspirin, the patient had no more abdominal symptoms, and we concluded NSAID-induced enteropathy was the cause of the symptoms. Meckel's diverticula are sometimes difficult to diagnose, but VE was able to depict the lesion clearly. Meckel's diverticulum is one of the best indications for VE.