Inverted Meckel's diverticulum preoperatively diagnosed using double-balloon enteroscopy

World J Gastroenterol. 2016 May 7;22(17):4416-20. doi: 10.3748/wjg.v22.i17.4416.

Abstract

An inverted Meckel's diverticulum is a rare gastrointestinal congenital anomaly that is difficult to diagnose prior to surgery and presents with anemia, abdominal pain, or intussusception. Here, we report the case of 57-year-old men with an inverted Meckel's diverticulum, who was preoperatively diagnosed using double-balloon enteroscopy. He had repeatedly experienced epigastric pain for 2 mo. Ultrasonography and computed tomography showed intestinal wall thickening in the pelvis. Double-balloon enteroscopy via the anal route was performed for further examination, which demonstrated an approximately 8-cm, sausage-shaped, submucosal tumor located approximately 80 cm proximal to the ileocecal valve. A small depressed erosion was observed at the tip of this lesion. Forceps biopsy revealed heterotopic gastric mucosa. Thus, the patient was diagnosed with an inverted Meckel's diverticulum, and single-incision laparoscopic surgery was performed. This case suggests that an inverted Meckel's diverticulum should be considered as a differential diagnosis for a submucosal tumor in the ileum. Balloon-assisted enteroscopy with forceps biopsy facilitate a precise diagnosis of this condition.

Keywords: Double-balloon enteroscopy; Epigastric pain; Heterotopic gastric mucosa; Inverted Meckel’s diverticulum; Small bowel tumor.

Publication types

  • Case Reports

MeSH terms

  • Double-Balloon Enteroscopy / methods*
  • Humans
  • Laparoscopy
  • Male
  • Meckel Diverticulum / diagnosis*
  • Meckel Diverticulum / pathology
  • Meckel Diverticulum / surgery
  • Middle Aged
  • Tomography, X-Ray Computed