Zobraziť v EDS

Massive Gastrointestinal Hemorrhage in an Adult Caused by Meckel's Diverticulum: A Case Report.

Uložené v:
Podrobná bibliografia
Názov: Massive Gastrointestinal Hemorrhage in an Adult Caused by Meckel's Diverticulum: A Case Report.
Autori: Zheng, Ludan, Li, Liangliang, Huo, Yubin, Su, Hui
Zdroj: International Medical Case Reports Journal; Sep2025, Vol. 18, p1253-1259, 7p
Predmety: GASTROINTESTINAL hemorrhage, MECKEL diverticulum, ADULTS, ENDOSCOPY, SURGERY, LAPAROSCOPY, DIAGNOSIS
Abstrakt: Meckel's diverticulum is one of the most common congenital anomalies of the gastrointestinal tract in pediatric populations worldwide. Although Meckel's diverticulum itself is usually asymptomatic, patients often present with complications such as gastrointestinal bleeding, Meckel's diverticulitis, intestinal perforation, and other associated symptoms. Notably, Meckel's diverticulum is relatively uncommon in adults, with cases complicated by acute massive gastrointestinal bleeding being particularly rare. We report the case of a 41-year-old man presenting with hematochezia for one day. Upon admission, his hemoglobin level dropped significantly from 98 g/L to 62 g/L within 24 hours. Contrast-enhanced computed tomography strongly suggested contrast media extravasation, indicating active bleeding. Subsequent gastrointestinal endoscopy, including colonoscopy, failed to identify obvious pathological findings. Mesenteric angiography successfully localized the bleeding vessels, but multiple embolization attempts were unsuccessful. The initial imaging and endoscopic modalities may not pinpoint the source of bleeding in this rare condition. Ultimately, a combined laparoscopic and endoscopic approach was employed, which successfully identified and localized the bleeding site in the Meckel's diverticulum. Laparoscopic intestinal resection was then performed, and postoperative pathological examination confirmed Meckel's diverticulum with ectopic gastric tissue. Meckel's diverticulum-induced bleeding in adults is severe yet rare, with nonspecific diagnostic features that often complicate timely identification. In managing the case of massive gastrointestinal hemorrhage, we achieved a successful outcome through combined laparoscopic intestinal resection and endoscopic surgery, with timely diagnosis and targeted intervention leading to complete recovery. This case underscores the critical role of a multimodal diagnostic and therapeutic strategy, particularly the integration of laparoscopy and endoscopy, in overcoming the challenges of nonspecific presentations. It serves as a valuable reference for clinicians, emphasizing that persistent diagnostic uncertainty in severe lower gastrointestinal bleeding should prompt consideration of rare etiologies like Meckel's diverticulum, and that a combined surgical-endoscopic approach can be pivotal in achieving definitive diagnosis and curative treatment. [ABSTRACT FROM AUTHOR]
Copyright of International Medical Case Reports Journal is the property of Dove Medical Press Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Databáza: Complementary Index
Popis
Abstrakt:Meckel's diverticulum is one of the most common congenital anomalies of the gastrointestinal tract in pediatric populations worldwide. Although Meckel's diverticulum itself is usually asymptomatic, patients often present with complications such as gastrointestinal bleeding, Meckel's diverticulitis, intestinal perforation, and other associated symptoms. Notably, Meckel's diverticulum is relatively uncommon in adults, with cases complicated by acute massive gastrointestinal bleeding being particularly rare. We report the case of a 41-year-old man presenting with hematochezia for one day. Upon admission, his hemoglobin level dropped significantly from 98 g/L to 62 g/L within 24 hours. Contrast-enhanced computed tomography strongly suggested contrast media extravasation, indicating active bleeding. Subsequent gastrointestinal endoscopy, including colonoscopy, failed to identify obvious pathological findings. Mesenteric angiography successfully localized the bleeding vessels, but multiple embolization attempts were unsuccessful. The initial imaging and endoscopic modalities may not pinpoint the source of bleeding in this rare condition. Ultimately, a combined laparoscopic and endoscopic approach was employed, which successfully identified and localized the bleeding site in the Meckel's diverticulum. Laparoscopic intestinal resection was then performed, and postoperative pathological examination confirmed Meckel's diverticulum with ectopic gastric tissue. Meckel's diverticulum-induced bleeding in adults is severe yet rare, with nonspecific diagnostic features that often complicate timely identification. In managing the case of massive gastrointestinal hemorrhage, we achieved a successful outcome through combined laparoscopic intestinal resection and endoscopic surgery, with timely diagnosis and targeted intervention leading to complete recovery. This case underscores the critical role of a multimodal diagnostic and therapeutic strategy, particularly the integration of laparoscopy and endoscopy, in overcoming the challenges of nonspecific presentations. It serves as a valuable reference for clinicians, emphasizing that persistent diagnostic uncertainty in severe lower gastrointestinal bleeding should prompt consideration of rare etiologies like Meckel's diverticulum, and that a combined surgical-endoscopic approach can be pivotal in achieving definitive diagnosis and curative treatment. [ABSTRACT FROM AUTHOR]
ISSN:1179142X
DOI:10.2147/IMCRJ.S541384