Life-threatening lower gastrointestinal bleeding in a 2-year-old boy treated by transcatheter embolization: uncommon features of a complicated Meckel diverticulum

Abstract

A 2.5-year-old boy presented with life-threatening lower gastrointestinal (GI) bleeding. Radiological investigation, including US, CT and 99 m-Technetium (Tc) pertechnate scintigraphy, was negative. Emergency visceral angiography was performed, showing a left-side, non-branching artery, originating from a side branch of the superior mesenteric artery (SMA) with extravasation of contrast material. At the same time, embolization of the bleeding point was performed, resulting in haemostasis. In the days following the procedure the boy developed an intestinal obstruction. At laparoscopy, a complicated Meckel diverticulum was resected.

Perforated meckel's diverticulum presenting as a hematocele on scrotal sonography

“…Meckel's diverticulum is the most common congenital anomaly of the alimentary tract, occurring in approximately 2% of the population 6. It is typically located at the antimesenteric border of the ileum, 45–60 cm proximal to the ileocecal valve,7 and constitutes a blind‐ending, true distal ileal diverticulum 5.…”

Angioembolisation of a Bleeding Meckel’s Diverticulum

“…On the other hand, it does not require general anaesthesia, presenting as a safer approach in a haemodynamically unstable patient. 3 It could also be definitive in patients who have unfavourable physical status for surgery. …”