title: Meckel's diverticulum bleeding diagnosed with magnetic resonance enterography: a case report.
abstract: Although the introduction of double-balloon enteroscopy has greatly improved the diagnostic rate, definite diagnosis of Meckel's diverticulum far from the ileocecal valve is still impossible in most cases. We explored the role of magnetic resonance (MR) enterography in detecting bleeding from Meckel's diverticulum that can not be confirmed via double-balloon enteroscopy. This study describes a case of male patient with bleeding from Meckel's diverticulum diagnosed with MR enterography of the small intestine. No bleeding lesion was found via colonoscopy, anal enteroscopy, or oral colonoscopy. MR enterography of the small intestine revealed an occupying lesion of 3.0 cm in the lower segment of the ileum. The patient was transferred to the Department of Abdominal Surgery of our hospital for surgical treatment. During surgery, a mass of 3 cm × 2 cm was found 150 cm from the ileocecal valve, in conjunction with congestion and edema of the corresponding mesangium. Intraoperative diagnosis was small bowel diverticulum with bleeding. The patient underwent partial resection of the small intestine. Postoperative pathology showed Meckel's diverticulum containing pancreatic tissues. He was cured and discharged 7 d after operation. We conclude that MR enterography of the small intestine has greatly improved the diagnosis rate of Meckel's diverticulum, particularly in those patients with the disease which can not be confirmed via double-balloon enteroscopy.
authors.affiliation: Department of Gastroenterology, Yu Huang Ding Hospital Affiliated to Qingdao University School of Medicine, Yantai 264000, Shandong Province, China. rzhoufu@126.com
authors.forename: Fu-Run
authors.initials: FR
authors.lastname: Zhou
authors.forename: Liu-Ye
authors.initials: LY
authors.lastname: Huang
authors.forename: Hai-Zhu
authors.initials: HZ
authors.lastname: Xie
mesh_terms: D000328:Adult; D001706:Biopsy; D003113:Colonoscopy; D058582:Double-Balloon Enteroscopy; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008467:Meckel Diverticulum / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D011237:Predictive Value of Tests; D016896:Treatment Outcome
keywords: Double-balloon enteroscopy; Magnetic resonance enterography; Meckel’s diverticulum