Inverted Meckel’s diverticulum: Two case reports and a review of the literature

ARTICLE HIGHLIGHTS

Case characteristics

The chief complaint of adults with inverted Meckel’s diverticulum is intermittent hematochezia, melena and/or abdominal colicky pain.

Clinical diagnosis

If an adult patient has chronic intermittent abdominal pain, melena, hematochezia, and/or complaints of intestinal obstruction, inverted Meckel’s diverticulum with intussusception should be considered.

Differential diagnosis

CT scans would be beneficial for differentiating among other diseases such as lipoma, inflammatory fibroid polyps, vascular malformations, lymphoma, and malignant tumors.

Laboratory diagnosis

In cases of intermittent hematochezia and/or melena, hemoglobin level would reveal anemia.

Imaging diagnosis

A characteristic coiled spring appearance or target sign are well known findings on CT scans.

Pathological diagnosis

Full-thickness inversion of diverticulum with or without heterotopic tissues such as stomach, pancreas etc. in hematoxylin and eosin staining would be the main finding of inverted Meckel’s diverticulum.

Treatment

Small bowel intussusception in adults, regardless of cause, requires prompt surgical management, such as segmental resection of the small bowel.

Related reports

Meckel’s diverticulum is a congenital anomaly of the omphalomesenteric duct remnant attached to the distal ileum and, when left untreated, the lifetime risk of developing complications requiring surgical treatment can be as high as 6.4%

Term explanation

Intussusception means a condition in which a proximal segment of bowel rolls into a distal part and causes intestinal obstruction.

Experiences and lessons

Following this report, we hope clinicians worldwide will be cautious regarding the use of capsule endoscopy to evaluate the cause of gastrointestinal bleeding in adults.