Wiley, Digestive Endoscopy, 1(19), p. 52-54, 2007
DOI: 10.1111/j.1443-1661.2007.00680.x
Full text: Download
A 31-year-old man was referred to our hospital for an evaluation of recurrent episodes of melena. Esophagogastroduodenoscopy, total colonoscopy, computed tomography and Tc-99 m scintigraphy were performed at a previous hospital, but the bleeding source remained unidentified. Double balloon enteroscopy (DBE) was performed with the use of an anal approach at our hospital. DBE was inserted into the ileum approximately 100 cm from the ileocecal valve, and then Meckel’s diverticulum was discovered. There was a circular ulceration in the middle part of the diverticulum without adherent blood clots, visible vessels nor heterotopic gastric mucosa. Meckel’s diverticulum was identified as the bleeding source, but an immediate risk of rebleeding was considered relatively low. The patient chose conservative therapy without surgery. Two years later, he is well, without further bleeding episodes. DBE made it possible not only to diagnose the existence of the Meckel’s diverticulum but also to assess the risk of rebleeding.