Meckel's Diverticulum Diagnosed by Double-Balloon Enteroscopy in an Adult Presenting With Obscure Gastrointestinal Bleeding

A 31-year-old man presented to our hospital because of a 2-month history of intermittent hematochezia. He had a history of a peptic ulcer 3 years previously. Physical examination was unremarkable other than pale conjunctivae. Laboratory tests showed a hemoglobin level of 8.2 g/dL (normal range, 14–16 g/dL). Esophagogastroduodenoscopy, colonoscopy, barium study, abdominal computed tomography scan, and capsule endoscopy were performed, but no definite bleeding lesion was identified. Retrograde double-balloon enteroscopy showed a 0.5-cm diverticulum containing hyperemic mucosa at approximately 80 cm proximal to the ileocecal valve (Figure A). In addition, the diverticulum can change its size and contour during the endoscopic inflation (Figure B). Meckel's diverticulum was highly suspected based on the features of endoscopy. Subsequently, technetium-99m pertechnetate scintigraphy confirmed the presence of a Meckel's diverticulum in the right lower quadrant of the abdomen (Figure C). The patient refused surgical treatment and showed no evidence of recurrent bleeding at a 6-month follow-up evaluation.

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