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Small-bowel capsule endoscopy in patients with Meckel's diverticulum: clinical features, diagnostic workup, and
Peter Baltes1, Xavier Dray2, Maria Elena Riccioni3
1Clinic for Internal Medicine, Agaplesion Bethesda Krankenhaus Bergedorf, Hamburg, Germany.
Background And Aims:
Meckel's diverticulum (MD) may remain silent or be associated with adverse events such as GI bleeding. The main aim of this study was to evaluate indicative small-bowel capsule endoscopy (SBCE) findings, and the secondary aim was to describe clinical presentation in patients with MD.
Methods:
This retrospective European multicenter study included patients with MD undergoing SBCE from 2001 until July 2021.
Results:
Sixty-nine patients with a confirmed MD were included. Median age was 32 years with a male-to-female ratio of approximately 3:1. GI bleeding or iron-deficiency anemia was present in nearly all patients. Mean hemoglobin was 7.63 ± 1.8 g/dL with a transfusion requirement of 52.2%. Typical capsule endoscopy (CE) findings were double lumen (n = 49 [71%]), visible entrance into the MD (n = 49 [71%]), mucosal webs (n = 30 [43.5%]), and bulges (n = 19 [27.5%]). Two or more of these findings were seen in 48 patients (69.6%). Ulcers were detected in 52.2% of patients (n = 36). In 63.8% of patients (n = 44), a combination of double lumen and visible entrance into the MD was evident, additionally revealing ulcers in 39.1% (n = 27). Mean percent SB (small bowel) transit time for the first indicative image of MD was 57% of the total SB transit time.
Conclusions:
Diagnosis of MD is rare and sometimes challenging, and a preoperative criterion standard does not exist. In SBCE, the most frequent findings were double-lumen sign and visible diverticular entrance, sometimes together with ulcers.
Insights
Small-bowel capsule endoscopy (SBCE) identified key findings like double lumens and visible entrances in Meckel's diverticulum (MD) patients, often with ulcers. These indicators aid in diagnosing this rare condition, which frequently causes GI bleeding.
Area of Science:
- Gastroenterology
- Diagnostic Endoscopy
Background:
- Meckel's diverticulum (MD) can be asymptomatic or cause gastrointestinal (GI) bleeding.
- Diagnosing MD preoperatively remains challenging due to a lack of definitive criteria.
Purpose of the Study:
- To evaluate indicative findings of small-bowel capsule endoscopy (SBCE) in patients with Meckel's diverticulum.
- To describe the clinical presentation of patients diagnosed with MD.
Main Methods:
- A retrospective, European multicenter study was conducted.
- Included patients with confirmed MD who underwent SBCE between 2001 and July 2021.
Main Results:
- Sixty-nine patients with MD were analyzed; most were male and presented with GI bleeding or anemia.
- Common SBCE findings included double lumen (71%), visible entrance (71%), mucosal webs (43.5%), and ulcers (52.2%).
- A combination of double lumen and visible entrance was observed in 63.8% of patients, often with ulcers.
Conclusions:
- SBCE is valuable for diagnosing Meckel's diverticulum.
- The most frequent SBCE findings are the double-lumen sign and visible diverticular entrance, frequently accompanied by ulcers.
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