Association of Meckelʼs Diverticulum with Crohnʼs Disease

Abstract

Purpose: A 21-year-old man presented with 2 months of colicky abdominal pain and iron deficiency anemia. He smoked tobacco and had a strong family history of Crohn's disease. Endoscopy with duodenal biopsies was negative. Colonoscopy showed a normal colon but patchy erythema in the terminal ileum (TI). Biopsies showed focal granulomatous inflammation of the TI with normal villous architecture (Figure 1). Continued abdominal pain prompted a SBFT and CT enterography that showed a persistent, fixed segment of the distal small bowel with a “coiled spring” appearance concerning for intussusception (Figure 2). The patient underwent laparoscopy with resection of a 10 cm small bowel Meckel's diverticulum (Figure 3). Conclusion: Meckel's diverticulum (MD) is the most prevalent congenital abnormality of the gastrointestinal tract (0.3%-4.0%). The prevalence of MD is maybe 3 times higher in Crohn's disease. We believe that our patient had small bowel Crohn's disease leading to Meckel's diverticulitis. This acted as a lead point for intussusception.Figure 1: TI - focal granulomas.Figure 2: CT enterography with intussusception.Figure 3: Resected Meckel's diverticulum with focal transmural infarction.