Iron Deficiency Anaemia: An Unusual Complication of Meckel’s Diverticulum

Abstract

Objectives: To describe a case of Meckel’s diverticulum with an unusual complication of iron deficiency anaemia due to chronic intestinal bleeding. Clinical Presentation and Intervention: A 12-year-old boy presented with bloody diarrhoea and abdominal pain in association with a long-standing history of black stools and progressive pallor. Biochemical tests revealed low serum iron (1.2 mmol/l) indicating iron deficiency anaemia and low serum albumin (29 g/l). The other tests were normal. Colonoscopy performed on the 8th day of hospitalization was normal. A technetium-99m pertechnetate scan showed an ectopic gastric mucosa in the Meckel’s diverticulum confirmed at surgery in the region of the antimesentric border and on histopathology. Conclusion: Findings indicated that the patient had a bleeding Meckel’s diverticulum, complicated by iron deficiency anaemia.

Clinical Features of Symptomatic Meckel's Diverticulum in Children: Comparison of Scintigraphic and Non-scintigraphic Diagnosis

“…Amount of bleeding may vary in diverse cases, ranging from a positive reaction to stool occult blood test to active massive bleeding that leads to failure in circulatory function. In particular, if the case is the latter one (massive bleeding) or continuous bleeding (even though the amount is small), this causes anemia due to loss of blood [15,16]. In this study, group 1 showed statistically significant differences in values of RBC count, Hb, Hct, MCV, and MCH, greater than those of group 2.…”

“…This is the best non-invasive method for pre-operative diagnosis of MD with ectopic gastric mucosa, which is used for patients with lower GI hemorrhage. Among children, detection rate using Meckel's scan was reported to be 90% [17], while sensitivity and specificity were reported to be 0.6-0.75, positive predictive value 1.0, and negative predictive value 0.77 [15]. Using Meckel's scan, non-specific false positive findings are not common while potential causes include intestinal obstructive disease, intussusception, inflammatory disease, arteriovenous malformation, ulcer, GI tumor, angioma, and anomaly of the urinary system (hydronephrosis, ectopic kidney, vesicoureteral reflex, and bladder diverticulum).…”

Prevalence and Determinants of Anemia and Iron Deficiency in Kuwait

“…Most studies of anemia in Kuwait have focused on the genetic causes of anemia such as sickle cell disease or thalassemia [ 6 , 7 ]. Estimates of nutritional causes of anemia have been based on small epidemiological studies, or clinical, or hospital-based studies [ 8 , 9 , 10 ] with limited generality. Past studies in Kuwait revealed that anemia is prevalent and may affect significant numbers of people across the life cycle [ 11 , 12 , 13 , 14 ].…”

Meckel’s diverticulum: misdiagnosis and late presentation

“…1 The anemia resulting from MD is usually secondary to a GI bleed. 41,45,49,50 The etiology of anemia presenting with a nonbleeding MD remains unknown.…”