A case of surgically-treated hemorrhaging Meckel’s diverticulum diagnosed by contrast-enhanced computed tomography and intraoperative endoscopy

Abstract

A 74-year-old man was admitted to our hospital complaining of bloody stools and anemia. Computed tomography with enhanced contrast showed leakage of contrast media to a diverticulum of the ileum. We suspected hemorrhage from a Meckel’s diverticulum. Bloody stools persisted, precluding small intestinal endoscopy, so emergency surgery was performed. A diverticulum of about 4 cm length was found in the ileum approximately 100 cm from the ileocecal valve. Observation via intraoperative endoscopy identified an ulcer with an exposed blood vessel in the diverticulum. Hemorrhage from a Meckel’s diverticulum was diagnosed, and wedge resection of the diverticulum at the base was performed. Pathological findings confirmed a true diverticulum, and heterotopic pyloric glands were observed in the circumference of the ulcer. When small intestinal endoscopy cannot be performed immediately, computed tomography with enhanced contrast and intraoperative endoscopy are useful techniques to employ in order to diagnose hemorrhage from Meckel’s diverticula.