A 31-year-old man was emergently admitted to the department of gastroenterological medicine in our hospital because of abrupt massive anal bleeding. Upper and lower gastrointestinal endoscopy and angiography faild to identify the bleeding site. A total of about 7500ml of anal bleeding was noted during these three days, but hemostasis was achieved conservatively. Intestinal fluoroscopy revealed a true diverticulum with peristalsis in the contralateral mesentery at 40cm from the terminal ileum. It was diagnosed as Meckel's diverticulum, but Tc scintigraphy did not visualize the diverticulum. Angiography confirmed abnormal vessels distributed in the diverticulum. It was determined that massive anal bleeding was originated from the Meckel's diverticulum. On November 15, 1996, a partial resection of the ileum including the diverticulum was performed under laparoscopy. Histological examination of the resected material revealed regeneration of epithelia at the top of the diverticulum which appeared to be a repairing process of acute mucosal lesion.
Differing from usual bleeding from Meckel's diverticulum, massive bleeding in this case was thought to occur from the acute mucosal lesion of the diverticulum.