Capsule endoscopy is useful diagnostic tool for diagnosing Meckel's diverticulum

Area of Science:

• Gastroenterology
• Diagnostic Endoscopy
• Congenital Anomalies

Background:

• Meckel's diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract.
• While often asymptomatic, MD can cause significant gastrointestinal bleeding (GIB) in adults.
• MD is a rare but important cause of obscure GIB.

Purpose of the Study:

• To evaluate the diagnostic utility of capsule endoscopy (CE) for identifying Meckel's diverticulum in adult patients with obscure GIB.
• To determine the effectiveness of CE in cases where conventional endoscopy and barium studies were inconclusive.

Main Methods:

• A retrospective analysis of 157 capsule endoscopy (CE) procedures performed for obscure GIB between October 2004 and December 2010.
• Patients included had undergone at least two nonconclusive upper/lower endoscopies and barium follow-through prior to CE.
• Data collected included CE findings, diagnostic yield, and correlation with surgical and histological results.

Main Results:

• Capsule endoscopy identified the source of bleeding in 44.6% (70/157) of patients.
• Meckel's diverticulum was diagnosed in 18.6% (13/70) of patients with identified bleeding sources.
• CE demonstrated a positive predictive value of 84.6% for MD, with characteristic findings including the double lumen sign, visible blood, and diaphragm sign.

Conclusions:

• Meckel's diverticulum should be considered in the differential diagnosis of obscure GIB in adults.
• Capsule endoscopy is an effective and promising tool for diagnosing MD in patients with obscure GIB.
• CE significantly aids in identifying the source of bleeding when other diagnostic modalities are non-conclusive.