Jayawickrama Ashan, Mohamed Ozaal Omar, Ranaweera Gayani, Fernandopulle Nilesh, Subasinghe Duminda
University Surgical Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka.
Department of Histopathology, Faculty of Medicine, University of Colombo, Sri Lanka.
SAGE Open Med Case Rep. 2024 Jul 24;12:2050313X241266480. doi: 10.1177/2050313X241266480. eCollection 2024.
Obscure gastrointestinal bleeding represents about 5% of all gastrointestinal haemorrhages which is characterized by continuous or recurrent bleeding from an undetermined source after an initial bidirectional endoscopy. Meckel's diverticulum is a rare but recognized cause of obscure gastrointestinal bleeding. A carefully selected line of investigations is paramount to localize the causative lesion in obscure gastrointestinal bleeding which is a challenge in subacute cases. We present a case of 35-year-old female with thalassemia minor and mild anaemia presented with acute gastrointestinal bleeding from the ectopic pancreatic mucosa of an Meckel's diverticulum where only a small focus of gastric tissue was identified histologically during the follow-up. This case discusses the rarity of this histological presentation of Meckel's diverticulum as obscure gastrointestinal bleeding and the importance of intraoperative decision-making and intraoperative enteroscopy in cases of obscure gastrointestinal bleeding when other tests are negative.
隐匿性胃肠道出血约占所有胃肠道出血的5%，其特征是在初次双向内镜检查后，出血源不明且持续或反复出血。梅克尔憩室是隐匿性胃肠道出血的一种罕见但已被认可的病因。精心选择一系列检查对于定位隐匿性胃肠道出血的致病病变至关重要，而这在亚急性病例中是一项挑战。我们报告一例35岁患有轻度地中海贫血和轻度贫血的女性，其因梅克尔憩室异位胰腺黏膜导致急性胃肠道出血，随访期间组织学检查仅发现一小片胃组织。该病例讨论了梅克尔憩室这种组织学表现作为隐匿性胃肠道出血的罕见性，以及在其他检查均为阴性的隐匿性胃肠道出血病例中，术中决策和术中肠镜检查的重要性。
