Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 16, 2015; 3(11): 970-972
Published online Nov 16, 2015. doi: 10.12998/wjcc.v3.i11.970
Lower gastrointestinal tract bleeding caused by dieulafoy-like lesion synchronous meckel diverticulum: A rare case report
Song-Hu Li, Guang-Yao Wu, Xiao-Dong Lin, Zong-Quan Wen, Mei-Ting Huang, Shao-Ping Yu, Hao Zhang
Song-Hu Li, Guang-Yao Wu, Xiao-Dong Lin, Zong-Quan Wen, Mei-Ting Huang, Shao-Ping Yu, Department of Gastroenterology, Dongguan Kanghua Hospital, Dongguan 523080, Guangdong Province, China
Hao Zhang, Department of General Surgery, Dongguan Kanghua Hospital, Dongguan 523080, Guangdong Province, China
Author contributions: Li SH, Wu GY contributed the main work of this article, they are both co-first authors; the study was guided by Yu SP; the endoscopy operation was performed by Wen ZQ, assisted by Lin XD; Zhang H performed the colectomy and exploring laparotomy; data were obtained by Li SH, Wu GY, Lin XD and Huang MT; data were analyzed by Wu GY; the report was written by Li SH and Wu GY; all authors approved the final version.
Institutional review board statement: This case report was exempt from the Ethics Committee of Dongguan Kanghua Hospital.
Informed consent statement: The patient involved in this study gave his written informed consent authorizing use and disclosure of his protected health information.
Conflict-of-interest statement: No conflicts of interest exist.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Shao-Ping Yu, MD, Department of Gastroenterology, Dongguan Kanghua Hospital, 1000# Dongguan Avenue, Dongguan 523080, Guangdong Province, China. yushaopingmd@163.com
Telephone: +86-769-23095553 Fax: +86-769-23095553
Received: May 20, 2015
Peer-review started: May 20, 2015
First decision: July 29, 2015
Revised: August 16, 2015
Accepted: September 16, 2015
Article in press: September 18, 2015
Published online: November 16, 2015
Abstract

Meckel diverticulum is an embryonic remnant of the Gastrointestinal duct which causes symptoms < 5% in the 2% population. Painless bleeding and abdominal pain are the most often reported symptoms. Dieulafoy lesion/dieulafoy-like lesion often cause upper gastrointestinal (GI) tract bleeding, but massive lower gastrointestinal bleeding is rare. We reported a 19-year-old male presented massive lower GI tract bleeding caused by Meckel diverticulum synchronous dieulafoy-like lesion.

Keywords: Lower gastrointestinal tract, Bleeding, Dieulafoy-like lesion, Meckel diverticulum, Endoscopy

Core tip: Dieulafoy-like lesion often causes upper gastrointestinal (GI) tract bleeding, and meckel diverticulum is another common cause of GI tract bleeding. The two of them happened at the same person is rare. We observed a 19-year-old man complained of upper stomachache was admitted to hospital. He underwent left hemi-colectomy on day 5 after admitted. Pathology confirmed the diagnosis of dieulafoy-like lension of descending colon. The bleeding ceased for 2 d. But another attack came on day 3 after surgery. He underwent a second laparotomy which united endoscopy, a 2 cm × 1.5 cm meckel diverticulum in terminal ileum was detected. Resection was performed. Pathology revealed meckel diverticulum. He was fully recovered with no sign of bleeding in the next year’s following up.