An 18-Year-Old Man with Bleeding From a Meckel's Diverticulum of the Terminal Ileum Diagnosed by 99mTc-Pertechnetate Scintigraphy (Meckel's Scan).

BACKGROUND Meckel's diverticulum represents the most common congenital anomaly of the gastrointestinal tract in the pediatric population. Although it is rarely symptomatic, painless rectal bleeding is the most common manifestation among pediatric patients. In contrast, Meckel's diverticulum is considerably rare in adults, in whom intestinal obstruction and diverticulitis are more frequent complications than bleeding. When it is suspected, a Meckel's scan is the most sensitive and specific diagnostic tool. Surgical excision remains the treatment of choice for Meckel's diverticulum. This report describes the case of an 18-year-old man with bleeding from a Meckel's diverticulum of the terminal ileum diagnosed by 99mTc-pertechnetate scintigraphy (Meckel's scan). CASE REPORT We report the case of an 18-year-old male patient who presented to the emergency department with a 24-hour history of 4 episodes of fresh rectal bleeding, associated with dizziness, nausea, palpitations, and a loss of consciousness. The patient underwent an extensive diagnostic workup, including computed tomography scan, sigmoidoscopy, colonoscopy, esophagogastroduodenoscopy, and capsule endoscopy, none of which revealed any abnormalities. A Meckel's scan eventually confirmed the presence of a Meckel's diverticulum on day 4 of admission, followed by a successful laparoscopic segmental resection on day 10 of admission. CONCLUSIONS Meckel's diverticulum, a common etiology of lower gastrointestinal bleeding in pediatric patients, presents a diagnostic challenge in adults, requiring a heightened index of suspicion. Clinical suspicion should be raised in cases with inconclusive initial investigations, particularly in younger adults.