Virtual enteroscopic images of inverted Meckel's diverticulum

Abstract

A 55-year-old man presented to our hospital with gastroinestinal bleeding. Standard oesophagogastroduodenoscopy and olonoscopy were performed, but the source of bleeding could ot be identified. Contrast enhanced CT was performed and an ntussusception was suspected in the small bowel. Meckel scan esult was negative. Virtual enteroscopy (VE) was then performed o check for the presence of a leading lesion. The depicted small owel is shown in 3D overview (Fig. 1a) and dissection view Fig. 1b). The small bowel was 543 cm long on VE. An 8 cm long edunculated polypoid lesion was found in the ileum 130 cm rom the ileocecal valve (asterisk in Fig. 1b). The stalk and the ead are indicated by arrow and arrowhead, respectively (Fig. 1c nd d). According to the results of VE, retrograde single balloon nteroscopy (SBE) was performed to obtain a histopathological iagnosis. A polypoid lesion with a long stalk was identified in the leum (Fig. 2a and b). Forceps biopsy of the head was taken and icroscopic examination revealed inflammatory exudates without pithelial component. Three possible diagnoses were considered: eiomyoma, gastrointestinal stromal tumour, and inverted Meckel’s iverticulum. Since the patient had suffered from small bowel leeding and there was a strong possibility of an intestinal obstrucion, a partial resection of the ileum was performed. The final iagnosis was an inverted Meckel’s diverticulum (Fig. 2c and d).