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Diagnostic accuracy of high-frequency ultrasound in bleeding Meckel diverticulum in children
Yanxiu Hu1, Xiaoman Wang2, Liqun Jia1
1Department of Ultrasound, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No.56 Nan Li Shi Road, Xi Cheng District, Beijing, 100045, China.
Insights
High-frequency ultrasound is a highly sensitive and specific tool for diagnosing Meckel diverticulum in children presenting with gastrointestinal bleeding. This imaging technique offers accurate detection for pediatric patients with this common cause of small bowel bleeding.
Area of Science:
- Pediatric Gastroenterology
- Diagnostic Imaging
- Surgical Pathology
Background:
- Meckel diverticulum is a significant cause of small bowel bleeding in pediatric patients.
- Ultrasonography shows promise as an alternative diagnostic tool, especially when radionuclide scanning is negative or clinical signs are atypical.
Purpose of the Study:
- To assess the diagnostic accuracy of high-frequency ultrasound for identifying Meckel diverticulum in children with gastrointestinal bleeding.
Main Methods:
- A retrospective analysis of 784 children admitted for bloody stools between February 2006 and December 2017.
- All children underwent ultrasonography; diagnoses were confirmed via pathological analysis or clinical follow-up.
- Diagnostic performance of ultrasonography was evaluated against confirmed diagnoses.
Main Results:
- The study included 784 children with various bleeding presentations (black/red stool, bright red stool, occult bleeding) and anemia in 62.4%.
- High-frequency ultrasound demonstrated a sensitivity of 93.6% and a specificity of 98.1% for diagnosing Meckel diverticulum.
Conclusions:
- High-frequency ultrasound is a highly sensitive and specific imaging modality for diagnosing Meckel diverticulum in children.
- This technique provides accurate diagnostic performance in the pediatric population presenting with gastrointestinal bleeding.
Background:
Meckel diverticulum is one of the most important causes of small bowel bleeding in children. Reports suggest that ultrasonography can be used as an alternative examination for children with negative radionuclide scanning results or children with atypical clinical manifestations.
Objective:
To evaluate the diagnostic accuracy of high-frequency ultrasound in children with bleeding Meckel diverticulum.
Materials And Methods:
We collected the data of children who were admitted to our hospital for the main symptom of bloody stool from February 2006 to December 2017. Ultrasonography was performed in all children. The final diagnosis was confirmed by pathological analysis or clinical follow-up observation. We evaluated the diagnostic performance of ultrasonography according to the final diagnosis.
Results:
A total of 784 eligible children were enrolled in the study. Presenting symptoms or findings included black and red stool in 528 (67.3%), bright red stool in 51 (6.5%) and obscure or occult bloody stool in 205 (26.1%). Anemia was diagnosed in 489 (62.4%). Ultrasonography diagnosed Meckel diverticulum with a sensitivity of 93.6% (95% confidence interval [CI] 91.0-95.6%) and a specificity of 98.1% (95% CI 95.9-99.3%).
Conclusion:
High-frequency ultrasound diagnosis of Meckel diverticulum in children has high sensitivity and specificity.
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