Images in Clinical Medicine

Meckel's Diverticulum in Action

See-Ching Chan, M.D., and Chung-Yau Lo, F.R.C.S., F.A.C.S.

N Engl J Med 2004; 350:e7February 19, 2004

• Slide

Article

A 26-year-old man presented with massive gastrointestinal hemorrhage and hypovolemic shock. His hemoglobin level dropped by 4 g per deciliter over a six-hour period. Emergency upper endoscopy to the second part of duodenum showed no abnormalities. Digital-subtraction visceral angiography was performed. Superior mesenteric arteriography revealed bleeding from a branch of the ileocolic artery (Panel A, arrow) that supplied the distal ileum. During laparotomy, the bleeding was localized to a 4-cm-long Meckel's diverticulum, located 55 cm proximal to the ileocecal junction. A Meckel's diverticulectomy was performed. A vessel corresponding to the tip of the feeding vessel in Panel A was visible on the mucosal surface of the diverticulum on the cut specimen (Panel B, arrow). The patient's postoperative recovery was unremarkable.

See-Ching Chan, M.D.
Chung-Yau Lo, F.R.C.S., F.A.C.S.
University of Hong Kong Medical Center, Hong Kong, China