Case Report

Bleeding Meckel’s Diverticulum in a 33-Year-Old Female Diagnosed with Video Capsule Endoscopy and a Technetium-99 m Pertechnetate Scan with a Favorable Response to H2 Blocker and PPI

Table 2

Identified cases of Meckel’s diverticulum treated with acid suppression.

Author and yearPresentation and diagnostic work-upMedicationOutcome

1. Kirkpatrick A. R., 1978 [8]A 27-year-old male with abdominal pain, gross bloody stool, and pallor, diagnosed using the Tc-99 m scan. The patient initially refused surgery due to financial reasonsCimetidine 300 mg 4x/day per os.Hemoglobin stabilized, and symptoms resolved for three months. Bleeding recurred upon stopping medication, and surgery was performed

2. Colins, J. C. Jr., 1980 [9]A 26-year-old female with rectal bleeding and abdominal pain. Initial diagnosis was made with barium studies; it was confirmed with the Tc-99 m scanCimetidine initially i.v. and then per os.There was no further bleeding. Elective surgery was performed 10 days later. Microscopic examination reiterated the diagnosis

3. Selker H. P., 1983 [10]A 23-year-old male with postprandial infraumbilical pain, stool occult blood, and microcytic hypochromic anemia. Barium studies demonstrated a large ileal diverticulum; the Meckel scan was normalCimetidine 400 mg 4x/day per os.Medication was stopped, and bleeding recurred. Cimetidine was restarted with good response, and surgery was performed five days later. Microscopic examination confirmed the diagnosis and demonstrated gastric-like mucosa

4. Xinias I. et al., 2012 [11]An 8-year-old boy with bright red stools, eventually diagnosed with wireless capsule endoscopyRanitidine 6 mg/kg of body weight 2x/day per os.Maintained symptom free for six months, after which surgery was performed. Microscopic examination confirmed the diagnosis

5. Dashan A., 2006 [12]A 9-year-old boy with overt gastrointestinal bleeding. Diagnosis was made with isotope scanningPantoprazole 40 mg/day i.v.Symptoms resolved, and surgery was performed 4 days after initial presentation

6. Ottaviano L. F. et al., 2016 [13]A 72-year-old female with beta-thalassemia trait presented with weakness and anemia. Double-balloon enteroscopy found midileal diverticulum with adjacent ulcerPPIThe patient refused surgery, and at 7 months’ follow-up, hemoglobin remained stable with no new episodes of melena or overt GI bleeding

7. Ottaviano L. F. et al., 2016 [13]An 80-year-old male with abdominal pain and anemia. CT showed distal small-intestinal wall thickening, and video capsule endoscopy demonstrated an ulcer. Double-balloon enteroscopy showed a nonbleeding jejunal angioectasia (treated with argon plasma coagulation) and ulcerated midileal mucosa surrounding a small diverticulumPPISymptom resolution up to study date

8. Manning R. J., 1987 [14]A 25-year-old male with copious gastrointestinal bleedingCimetidine 300 mg 4x/day and ranitidine 150 mg 3x/day per os.Despite two H2 blockers and aggressive i.v. fluid and blood replacement, bleeding persisted, and emergent surgery was performed. Meckel’s diverticulum was found intraoperatively and confirmed microscopically