International journal of surgery case reports · 2026
Lower gastrointestinal bleeding secondary to sigmoid diverticulosis with incidental Crohn's disease and Meckel's diverticulum: a case report.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Sacasa Federico, Pereira Santana Cristian Geovanny
Аннотация
INTRODUCTION: Lower gastrointestinal bleeding (LGIB) in older adults is most commonly caused by diverticular disease. Concomitant pathology may be encountered during evaluation, particularly in patients with multiple comorbidities.
PRESENTATION OF CASE: A 78-year-old man presented with painless hematochezia and hypovolemic shock while receiving clopidogrel. After stabilization, colonoscopy identified a sigmoid diverticulum with an adherent clot, which was treated with injection and clipping. During the same examination, an ulcerated ileocecal valve was noted. Retrograde single-balloon enteroscopy was subsequently performed, demonstrating terminal ileal ulceration consistent with Crohn's disease and an incidental Meckel's diverticulum.
DISCUSSION: Hemorrhage control was achieved endoscopically and attributed to diverticular bleeding. Further evaluation was undertaken based on the ileocecal finding, allowing direct assessment of the terminal ileum.
CONCLUSION: In this case, targeted evaluation, prompted by a focal ileocecal abnormality, identified silent Crohn's disease and an incidental Meckel's diverticulum; while unrelated to the bleeding source, their recognition informed subsequent management and surveillance.
PRESENTATION OF CASE: A 78-year-old man presented with painless hematochezia and hypovolemic shock while receiving clopidogrel. After stabilization, colonoscopy identified a sigmoid diverticulum with an adherent clot, which was treated with injection and clipping. During the same examination, an ulcerated ileocecal valve was noted. Retrograde single-balloon enteroscopy was subsequently performed, demonstrating terminal ileal ulceration consistent with Crohn's disease and an incidental Meckel's diverticulum.
DISCUSSION: Hemorrhage control was achieved endoscopically and attributed to diverticular bleeding. Further evaluation was undertaken based on the ileocecal finding, allowing direct assessment of the terminal ileum.
CONCLUSION: In this case, targeted evaluation, prompted by a focal ileocecal abnormality, identified silent Crohn's disease and an incidental Meckel's diverticulum; while unrelated to the bleeding source, their recognition informed subsequent management and surveillance.