An Adult Case of Bleeding Meckel's Diverticulum without Ectopic Tissue

Tomoji Nishimoto, Seiichii Akioka, Mitsuhiro Fujino, Hiroyuki Ameno, Sigeatsu Tanimukai, Hisashi Amaike, Tatsuyuki Ann, Eito Ikeda, Fumitaka Muto, Kyozoh Hashimoto, Hideaki Kurioka, Takao Ohuchi, Kannichi Tanaka, Yoshihiro Harada, Gennko Ishimine

Division of Surgery, Kyoto First Red Cross Hospital

A case of hemorrhagic Meckel's diverticulum, which was difficult to diagnose preoperatively, is descrived. The patient was a 22-year-old woman who had had repeated episodes of unexplained digestive bleeding intermittently from the age of 17 years. The patient was evaluated by close examinations of the digestive tract, ^{99 m}Tc phytate abdominal scan, ^{99 m}Tc pertechnetate abdominal scan, and angiography at each episode, but no findings were obtained except that ^{99 m}Tc phytate abdominal scan revealed an accumulation in the lower abdomen. She developed massive bloody stool in August, 1989 and was admitted to the hospital. Although the site of hemorrhage could not be determined, laparotomy was performed with suspicion of Meckel's diverticulum. A Meckel's diverticulum 3×4 cm was found in the small intestine 50 cm from the ileal terminal and was resected. This Meckel's diverticulum had no ectopic tissues but showed an annular ulcer near its base. In young patients repeatedly presenting with unexplained digestive bleeding, laparotomy should be considered with hemorrhagic Meckel's diverticulum in mind if ^{99 m}Tc phytate abdominal scan is positive for accumulation in the lower abdomen.

Key words
intestinal bleeding, Meckel's diverticulum, ^{99 m}Tc phytate abdominal scan

Reprint requests
Tomoji Nishimoto Division of Surgery, Kyoto First Red Cross Hospital
15-749 Honmachi, Higashiyama-ku, Kyoto, 605 JAPAN

Accepted
September 12, 1990

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