Hariharan Abishek, Amin Shefali, Munankami Salina, Shrestha Manish, Altomare John
Internal Medicine, Tower Health Medical Group, West Reading, USA.
General Medicine, Kathmandu Medical College, Kathmandu, NPL.
Cureus. 2023 Jul 11;15(7):e41723. doi: 10.7759/cureus.41723. eCollection 2023 Jul.
A 51-year-old male presented to the hospital with recurrent gastrointestinal bleeding. Prior work up with an esophagogastroduodenoscopy (EGD), colonoscopy, and video capsule endoscopy failed to reveal a bleeding source. Given a history of a terminal ileum diverticulum noted on previous colonoscopy and persistence of hematochezia, a Meckel's scan was performed, which revealed abnormal uptake suspicious for a Meckel's diverticulum containing ectopic gastric mucosa. After surgical resection, pathology confirmed a Meckel's diverticulum with gastric heterotopia. This case highlights the importance of considering Meckel's diverticulum for instances of recurrent gastrointestinal bleeding, especially in patients who are still symptomatic despite an extensive workup. Moreover, it is important to note that a Meckel's diverticulum can be missed on video capsule endoscopy.
一名51岁男性因反复胃肠道出血入院。此前进行的食管胃十二指肠镜检查（EGD）、结肠镜检查和视频胶囊内镜检查均未发现出血源。鉴于既往结肠镜检查发现末端回肠憩室病史且便血持续存在，遂行梅克尔扫描，结果显示异常摄取，怀疑为含有异位胃黏膜的梅克尔憩室。手术切除后，病理证实为伴有胃异位的梅克尔憩室。该病例凸显了对于反复胃肠道出血病例考虑梅克尔憩室的重要性，尤其是在经过广泛检查仍有症状的患者中。此外，需要注意的是，视频胶囊内镜检查可能会漏诊梅克尔憩室。
