Intussuscepted Polypoid Meckel's Diverticulum Presenting With Gastrointestinal Bleeding in a Young Adult

A 22-year-old female patient with a recent hospitalization for gastrointestinal bleeding presented with recurrent hematochezia and a positive shock index. Previous investigations, including endoscopy and wireless small bowel capsule, were non-diagnostic. CT angiography revealed extravasation in the...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2024-01, Vol.16 (1), p.e51744
Main Authors: Konstantakis, Christos, Mantzios, Petros, Sotiropoulos, Christos, Anesidis, Stathis, Thomopoulos, Konstantinos C
Format: Article
Language:English
Subjects:
Abdomen
Anemia
Biopsy
Dehydrogenases
Embolization
Emergency medical care
Endoscopy
Females
Gastroenterology
General Surgery
Hemoglobin
Intestinal obstruction
Iron
Ischemia
Medical imaging
Neutrophils
Polyethylene glycol
Small intestine
Soil erosion
Young adults
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Summary:A 22-year-old female patient with a recent hospitalization for gastrointestinal bleeding presented with recurrent hematochezia and a positive shock index. Previous investigations, including endoscopy and wireless small bowel capsule, were non-diagnostic. CT angiography revealed extravasation in the ileum. Initial tests like technetium-99m scintigraphy and ileocolonoscopy were negative. Repeat wireless small bowel capsule identified a partially ulcerated polypoid mass in the distal ileum. At surgical exploration, an intussuscepted Meckel's diverticulum was identified and resected. A histopathologic examination confirmed the diagnosis. Meckel's diverticulum is a rare cause of gastrointestinal bleeding in adults. Preoperative diagnosis can be challenging. Reports of a polypoid morphology are very scarce in indexed literature and mostly derive from investigation with device-assisted enteroscopy. We report this extremely rare finding at capsule endoscopy to raise clinician awareness and to discuss diagnostic difficulties associated with similar cases, such as the negative scintigraphy result and the optimal timing of repeat capsule endoscopy.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.51744