Bleeding Meckel's Diverticulum in Children: The Diagnostic Value of Double-Balloon Enteroscopy

Area of Science:

• Pediatric Gastroenterology
• Surgical Diagnostics
• Congenital Anomalies

Background:

• Meckel's diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract.
• Diagnosing MD, especially when causing bleeding in children, presents challenges.
• Traditional diagnostic methods may not always be conclusive.

Purpose of the Study:

• To evaluate the diagnostic accuracy of double-balloon enteroscopy (DBE) for pediatric Meckel's diverticulum.
• To assess the safety of DBE in diagnosing bleeding MD in children.
• To compare DBE findings with Meckel's scan and exploratory laparoscopy.

Main Methods:

• Retrospective analysis of 42 children with suspected Meckel's diverticulum (2012-2013).
• All patients underwent Meckel's scan; DBE was performed for negative scans.
• Exploratory laparoscopy confirmed diagnoses; DBE findings were correlated.

Main Results:

• 40 of 42 patients had confirmed Meckel's diverticulum via laparoscopy.
• Meckel's scan had 36 positive and 6 negative results (2 false positives).
• DBE diagnosed MD in 6 patients with negative Meckel's scans, leading to immediate surgery; ectopic gastric mucosa was 100% present.

Conclusions:

• Double-balloon enteroscopy is a reliable diagnostic tool for pediatric bleeding Meckel's diverticulum.
• DBE is particularly valuable in cases with negative Meckel's scans.
• DBE facilitates timely surgical intervention and confirms ectopic gastric mucosa presence.