Related Experiment Videos
Segmental dilatation of the ileum presenting with acute intestinal bleeding
A Porreca1, A Capobianco, C Terracciano
1Department of Emergency Surgery, Santobono Hospital, Naples, Italy.
Insights
A 5-month-old infant experienced acute intestinal bleeding due to an ulcerated segmental ileal dilatation. This rare condition, caused by heterotopic gastric mucosa, led to severe anemia, requiring surgical intervention.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Pathology
Background:
- Segmental intestinal dilatation is a rare congenital anomaly.
- Acute intestinal bleeding in infants can be life-threatening.
- Meckel's diverticulum is a common cause of such bleeding, often leading to initial diagnostic suspicion.
Observation:
- A 5-month-old infant presented with profuse rectal bleeding and acute anemia (Hb 5.3 g/dL).
- Initial investigations, including plain X-ray, were normal, and symptoms mimicked a bleeding Meckel's diverticulum.
- Laparoscopy revealed segmental ileal dilatation as the source of bleeding.
Findings:
- Histopathological examination confirmed an ulcer within the dilated ileum.
- The ulcer was attributed to the presence of heterotopic gastric mucosa.
- This finding identified a rare cause of acute gastrointestinal hemorrhage in an infant.
Implications:
- Highlights the importance of considering segmental ileal dilatation in the differential diagnosis of infant gastrointestinal bleeding.
- Underscores the diagnostic value of laparoscopy in unclear cases of pediatric abdominal emergencies.
- Provides insight into the etiopathogenesis of this rare condition, linking it to heterotopic gastric mucosa.
Abstract:
The authors report a case of acute intestinal bleeding caused by ulcerated segmental ileal dilatation occurring in a 5-month-old infant. The profuse emission of dark red blood per rectum caused acute anemia (Hb 5.3 g/dL). Because of absence of any other sign and symptom and normal plain x-ray, a bleeding Meckel's diverticulum was suspected. Laparoscopy was performed showing the ileal dilatation, and through an enlarged port incision the bowel was exteriorized and resected. Histology results showed an ulcer caused by heterotopic gastric mucosa. The etiopathogenesis and clinical manifestations of segmental intestinal dilatation are discussed.