Case Report

Obscure Gastrointestinal Bleeding due to Meckel’s Diverticulum: A Frustrating Problem: Report of a Case

  • Alper Parlakgumus Parlakgumus
  • Sedat Belli
  • Tamer Çolakoğlu
  • Akın Mehmet Tarım
  • Fazilet Kayaselçuk
  • Neşe Torun
  • Kenan Çalışkan
  • Sedat Yıldırım

Turk J Colorectal Dis 2012;22(2):57-61

Meckel’s diverticulum is a true intestinal diverticulum that arises in the anti-mesenteric part of the ileum, constituting all layers of the intestinal wall. The most commonly encountered complication of Meckel’s diverticulum is gastrointestinal bleeding in the second decade, and intestinal obstruction in the fourth decade. In this article, a 17 years old, male patient, with no identified source of the gastrointestinal bleeding determined with diagnostic tests, is described. The patient was consulted to general surgery, after a 6 days of delay period and transfusion of 16 units of erythrocyte suspensions. So emergent surgical intervention was undertaken. Because of the possibility of a need for an intra-operative enteroscopy, laparotomy was performed. During the exploration, Meckel’s Diverticulum was detected. The source of bleeding was distal to the Meckel’s Diverticulum, and intraluminal blood was observed. Segmental small bowel resection is performed. Post-operatif period was uneventful and the patient was discharged. Despite the adequate diagnostic measures performed in the pre-operative period, localizing the source of gastrointestinal bleeding can be challenging for the clinicians and frustrating for the patient and as presented in this case. In conclusion, standart diagnostic tests can be insufficient, for the patients suffering from an obscure gastrointestinal bleeding, and emergent surgical intervention can be required for he cases with severe bleeding. With for this case report, obscure gastrointestinal bleeding and one of the reasons of this challange ‘ Meckel’s Diverticulum’ are reviewed in the light of the literature.

Keywords: Meckel’s diverticulum, Obscure gastrointestinal bleeding