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Severe obscure gastrointestinal bleeding from Meckel's diverticulum with predominant ectopic pancreatic tissue

Ashan Jayawickrama1, Omar Mohamed Ozaal1, Gayani Ranaweera2

  • 1University Surgical Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka.

SAGE Open Medical Case Reports
|July 26, 2024
PubMed

Insights

Obscure gastrointestinal bleeding can stem from Meckel's diverticulum with ectopic pancreatic mucosa. This rare cause highlights the need for intraoperative enteroscopy when standard diagnostics fail.

Area of Science:

  • Gastroenterology
  • Surgical Pathology

Background:

  • Obscure gastrointestinal bleeding (OGIB) accounts for 5% of GI hemorrhages, often with an unidentified source after standard endoscopy.
  • Meckel's diverticulum is an uncommon but established cause of OGIB.

Observation:

  • A 35-year-old female with thalassemia minor and anemia presented with acute GI bleeding.
  • The bleeding source was identified as ectopic pancreatic mucosa within a Meckel's diverticulum.
  • Histological examination revealed a small focus of gastric tissue.

Findings:

  • This case highlights a rare histological presentation of Meckel's diverticulum causing OGIB.
  • Ectopic pancreatic mucosa in Meckel's diverticulum can manifest as significant gastrointestinal bleeding.
  • Standard investigations may fail to identify the source in subacute cases.

Implications:

  • Intraoperative decision-making and enteroscopy are crucial for diagnosing OGIB when initial tests are negative.
  • Accurate histological identification of ectopic tissues is vital for understanding Meckel's diverticulum-related bleeding.
  • This case underscores the importance of considering rare pathologies in refractory OGIB.
Keywords:
Meckel’s diverticulumdiagnostic laparoscopyectopic pancreatic tissueovert obscure gastrointestinal bleeding

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