Angiographic diagnosis of Meckel's diverticulum in an adult patient with negative scintigraphy

Authors

  • Mark Kovacs
  • Jonathan Botstein
  • Stuart Braverman

DOI:

https://doi.org/10.3941/jrcr.v11i3.2032

Keywords:

Meckel diverticulum, Meckel's diverticulum, omphalomesenteric duct, vitelline artery, vitellointestinal artery, angiography, mesenteric angiogram, Technetium 99m pertechnetate, scintigraphy, Meckel's scan, ileum, hemorrhage

Abstract

A Meckel's diverticulum was diagnosed by mesenteric angiography in a 34 year-old patient who presented with hematochezia and dropping hemoglobin.  The case demonstrates the challenges often encountered in workup of occult gastrointestinal (GI) bleeding, and shows that angiographic diagnosis of Meckel's diverticulum is possible, even in the absence of angiographic evidence of active extravasation. Our patient had a previous non-diagnostic workup including upper and lower endoscopy, videocapsulography, and Technetium-99m  pertechnetate (Tc-99m) scintigraphy.  Visceral angiogram demonstrated the presence of a persistent vitelline artery, diagnostic of Meckel's diverticulum.  While no active extravasation was seen at the time of the angiogram, operative specimen demonstrated a Meckel's diverticulum with ectopic gastric mucosa and intraluminal hemorrhage. 

Author Biographies

Mark Kovacs

Assistant Professor, Radiology

Jonathan Botstein

Resident, Radiology

Stuart Braverman

Attending Radiologist (Interventional)

Published

2017-03-23

Issue

Section

Interventional Radiology