Wireless Capsule Endoscopy Detects Meckel's Diverticulum in a Child with Unexplained Intestinal Blood Loss

Area of Science:

• Gastroenterology
• Pediatric Surgery
• Diagnostic Imaging

Background:

• Meckel's diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract, affecting approximately 2% of the population.
• While often asymptomatic, symptomatic MD can present diagnostic challenges, particularly in pediatric patients.
• Gastrointestinal bleeding is a potential complication of Meckel's diverticulum.

Observation:

• An 8-year-old boy presented with recurrent episodes of significant gastrointestinal bleeding.
• Initial diagnostic evaluations, including GI scintigraphy and colonoscopy, were negative for the source of bleeding.
• Despite normal findings on upper endoscopy and colonoscopy during a second bleeding episode, further investigation was warranted.

Findings:

• Radiolabeling of blood constituents with (99m)Tc indicated a potential lesion in the ileocecal area.
• Wireless capsule endoscopy successfully identified a Meckel's diverticulum as the cause of the gastrointestinal bleeding.
• This case highlights the diagnostic difficulties associated with symptomatic Meckel's diverticulum.

Implications:

• Wireless capsule endoscopy should be considered in cases of obscure gastrointestinal bleeding, especially when conventional endoscopic methods are inconclusive.
• Early and accurate diagnosis of Meckel's diverticulum is essential for appropriate management and to prevent complications.
• This case underscores the importance of advanced diagnostic tools in pediatric gastroenterology for identifying rare congenital anomalies.