Talat Nur.
Inverted Meckel`s Diverticulum as a cause of obscure lower gastrointestinal bleeding.
J Coll Physicians Surg Pak Jan ;13(9):532-3.

A 52-year-old postmenopausal female, with no co-morbidity presented with peri-umbilical colicky abdominal pain for one week. Similar episodes of pain without any associated vomiting, anorexia or any weight loss had been experienced in the last one year. There was no history of per vaginal blood loss. Stool examination revealed occult blood. She was on regular hematinics. Complete blood count showed a hematocrit of 28% at the time of admission despite receiving multiple blood transfusions and iron supplements. Esophagogastroduodenoscopy and colonoscopy were non-contributory. A small bowel enema was then performed which revealed an intraluminal polypoidal filling defect in the terminal ileum. The patient underwent laparotomy through a midline incision and an inverted Meckel`s diverticulum resulting in intussus-ception was identified. About 8 cms of the small bowel was resected and intestinal continuity was restored. Inspection of the specimen demonstrated a 6.5 cm inverted diverticulum which had served as a lead point for an intussusception. She had a smooth postoperative recovery and maintained her hematocrit postoperatively without any hematinics when reviewed in the outpatient clinic after two weeks. Histology of the resected specimen showed ectopic gastric mucosa with ulceration of the adjacent ileum.

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