Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
권호 표지

A Case of Meckel's Diverticulum Diagnosed for Recurrent Hematochezia in Old Age

고령에서 반복하는 혈변으로 진단된 멕켈 게실 1예

  • Kim, Dong-Kyun (Institute for Digestive Research, Digestive Disease Center, Department of Internal Medicine, Soonchunhyang University College of Medicine) ;
  • Kim, Jin-Oh (Institute for Digestive Research, Digestive Disease Center, Department of Internal Medicine, Soonchunhyang University College of Medicine) ;
  • Kim, Hyun-Gun (Institute for Digestive Research, Digestive Disease Center, Department of Internal Medicine, Soonchunhyang University College of Medicine) ;
  • Lee, Tae-Hee (Institute for Digestive Research, Digestive Disease Center, Department of Internal Medicine, Soonchunhyang University College of Medicine) ;
  • Jung, Yoon-Ho (Institute for Digestive Research, Digestive Disease Center, Department of Internal Medicine, Soonchunhyang University College of Medicine) ;
  • Cho, Joo-Young (Institute for Digestive Research, Digestive Disease Center, Department of Internal Medicine, Soonchunhyang University College of Medicine) ;
  • Lee, Joon-Seong (Institute for Digestive Research, Digestive Disease Center, Department of Internal Medicine, Soonchunhyang University College of Medicine) ;
  • Jin, So-Young (Department of Pathology, Soonchunhyang University College of Medicine)
  • 김동균 (순천향대학교 의과대학 내과학교실 소화기연구소) ;
  • 김진오 (순천향대학교 의과대학 내과학교실 소화기연구소) ;
  • 김현건 (순천향대학교 의과대학 내과학교실 소화기연구소) ;
  • 이태희 (순천향대학교 의과대학 내과학교실 소화기연구소) ;
  • 정윤호 (순천향대학교 의과대학 내과학교실 소화기연구소) ;
  • 조주영 (순천향대학교 의과대학 내과학교실 소화기연구소) ;
  • 이준성 (순천향대학교 의과대학 내과학교실 소화기연구소) ;
  • 진소영 (순천향대학교 의과대학 병리학교실)
  • Received : 2009.12.28
  • Accepted : 2010.03.26
  • Published : 2010.05.30
⟨ Previous Next ⟩

Abstract

The small bowel is the most common site of an unknown origin of gastrointestinal bleeding. Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract in children. The complications from Meckel's diverticulum such as bleeding decrease with age, and so Meckel's diverticular bleeding is very rare in old age patients. The diagnosis of Meckel's diverticulum may be very difficult and especially in old age patients. Capsule endoscopy and double balloon enteroscopy have recently become useful diagnostic tools for assessing diverticular bleeding and small bowel lesions as these techniques can examine the entire small intestine. We report here on a case of Meckel's diverticulum that was detected by capsule endoscopy and double balloon enteroscopy and this was confirmed by surgery in a 76-year-old man with recurrent hematochezia.

불분명한 위장관 출혈의 가장 흔한 원인은 소장에 있다. 멕켈 게실은 위장관에서 발생하는 가장 흔한 선천성 기형이지만 소아에서 흔하고 출혈 등의 합병증도 연령이 증가하면서 감소하기 때문에 고령에서 멕켈 게실에 의한 출혈은 매우 드물다. 멕켈 게실의 진단은 쉽지 않으며 특히 고령일 경우 매우 어렵다. 최근에는 캡슐내시경과 이중풍선 소장내시경으로 전 소장을 관찰할 수 있어 게실 출혈이나 소장의 병변을 진단하는데 많은 도움이 되고 있다. 저자들은 반복하는 혈변을 주소로 내원한 76세 남자에서 캡슐내시경 및 이중풍선 소장내시경을 이용하여 멕켈 게실을 진단하고 수술로 확진하여 이를 보고한다.

Keywords

References

  1. Kim HJ, Shim CS, Lee SH, et al. The usefulness of capsule endoscopy in patients with obscure gastrointestinal bleeding. Korean J Gastrointest Endosc 2005;31:140-146.
  2. Jung HG, Wi JH, Kim JO, et al. Usefulness of double balloon enteroscopy in obscure gastrointestinal bleeding. Korean J Med 2007;73:267-273.
  3. Heo WY, Chaa JM, Jung SW, et al. A case of a Meckel's diverticular bleeding dignosed by the use of dobule balloon enteroscopy. Korean J Gastrointest Endosc 2008;37:364-368.
  4. Song HJ, Shim KN, Ryu KH, et al. A case of bleeding Medkel's diverticulum diagnosed by wireless capsule endoscopy. Korean J Gastrointest Endosc 2006;32:387-391.
  5. Park SM, Chun HJ, Jeen YT, et al. A case of chronic gastrointestinal bleeding from a Meckel's diverticulum detected by wireless capsule endoscopy. Korean J Gastroenterol 2004;43:125-128.
  6. Park JH, Sohn CI. A case of Meckel's diverticulum diagnosed by double balloon enteroscopy. Korean J Gastroenterol 2006;47:1-4.
  7. Martin JP, Connor PD, Charles K. Meckel's diverticulum. Am Fam Physician 2000;61:1037-1042, 1044.
  8. Park JJ, Wolff BG, Tollefson MK, Walsh EE, Larson DR. Meckel diverticulum: the Mayo Clinic experience with 1476 patients (1950-2002). Ann Surg 2005;241:529-533. https://doi.org/10.1097/01.sla.0000154270.14308.5f
  9. Elsayes KM, Menias CO, Harvin HJ, Francis IR. Imaging manifestations of Meckel's diverticulum. AJR Am J Roentgenol 2007;189:81-88. https://doi.org/10.2214/AJR.06.1257
  10. Dumper J, Mackenzie S, Mitchell P, Sutherland F, Quan ML, Mew D. Complications of Meckel's diverticula in adults. Can J Surg 2006;49:353-357.
  11. Rossi P, Gourtsoyiannis N, Bezzi M, et al. Meckel's diverticulum: imaging diagnosis. AJR Am J Roentgenol 1996;166:567-573. https://doi.org/10.2214/ajr.166.3.8623629