Bleeding Meckel’s in Pregnancy: A Rare Cause of a Rare Phenomenon

Rahul R Sima,Clement S Rajan,Srikanth K Aithal

doi:10.4236/ss.2016.72013

Abstract

Meckel’s diverticulum complicating pregnancy is indeed a rare occurrence. The anatomical and physiological changes that occur in pregnancy make the clinical presentation and preoperative diagnosis of an acute abdomen extremely difficult. Even imaging modalities have to be used with caution keeping in mind the risks associated for both mother and fetus. Treatment of such cases must be prompt and accurate with a high index of suspicion in order to prevent high rate of maternal and fetal morbidity. We report one such case of bleeding of Meckel’s diverticulum. The most common cause of bleeding in a Meckel’s is ectopic gastric mucosa. When we performed an exploratory laparotomy we found to our surprise a bleeding Meckel’s diverticulum. Further investigations revealed a very interesting histopathological report of endometriosis as the cause of bleed.

Highlights

Meckel’s diverticulum is a congenital anomaly, remnant of the vitello-intestinal duct which is present in 2% of population on the antimesenteric border of the small intestine, about 60 cm from the ileo-cecal junction [1] [2]. 20% of cases have mucosa with heterotropic epithelium, gastric, colonic or even pancreatic tissue
A 28 years old lady presented to our hospital in the 24th week of her second pregnancy with non bilious, non blood tinged vomiting 2 - 3 episodes per day for the past week, burning sensation while passing urine for a week, dark coloured stools for 3 days
She complained of mild, dull aching, non radiating pain in the lower abdomen for a day

Summary

Introduction

Meckel’s diverticulum is a congenital anomaly, remnant of the vitello-intestinal duct which is present in 2% of population on the antimesenteric border of the small intestine, about 60 cm from the ileo-cecal junction [1] [2]. 20% of cases have mucosa with heterotropic epithelium, gastric, colonic or even pancreatic tissue. 20% of cases have mucosa with heterotropic epithelium, gastric, colonic or even pancreatic tissue. Meckel’s diverticulum is a congenital anomaly, remnant of the vitello-intestinal duct which is present in 2% of population on the antimesenteric border of the small intestine, about 60 cm from the ileo-cecal junction [1] [2]. Equal distribution in both males and females is seen; symptomatic Meckel’s is more in males with hemorrhage due to ulceration of peptic mucosa, intussusceptions and Meckel’s diverticulitis, with or without perforation due to obstruction mimicking appendicitis being the common presentations [1] [3].

Case Report

Discussion

Findings

Conclusion