Meckel's diverticulum as a cause of gastrointestinal bleeding

Meckel's diverticulum, the most common congenital anomaly of the gastrointestinal tract, is often asymptomatic. Lack of complete resorption of the omphalomesenteric duct is an important cause of Meckel's diverticulum. Gastrointestinal (GI) bleeding is a major complication of Meckel's diverticulum. Herein, we reported a case of obscure gastrointestinal bleeding secondary to Meckel's diverticulum in small intestine detected by double-balloon enteroscopy. A 32-year-old male was admitted to the Department of Gastroenterology due to a 4-year history of intermittent hematochezia. Half a month before this admission, abdominal computed tomography scans showed high density in intestinal tract, and magnetron capsule endoscopy showed dark red blood from the end of the ileum to the ascending colon, but did not identify the source of bleeding. At this admission, hemoglobin concentration was 117 g/L. Double-balloon enteroscopy via anal route was performed, and found a large diverticulum in the middle part of the ileum, which was marked by two metal clips, with a superficial ulcer on its inner wall. Thus, Meckel's diverticulum was diagnosed. Subsequently, he underwent surgery. During surgery, a small intestinal diverticulum with a size of about 5.0cm×2.0cm was located nearly 120cm away from the ileocecal part. Small intestinal diverticulectomy was performed. He did not develop any recurrent hematochezia during follow-up.