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Demystifying Meckel's diverticulum - a guide for the gastroenterologist

Kimberley Butler1, Thomas Peachey2, Reena Sidhu1,3

  • 1Academic Unit of Gastroenterology, Royal Hallamshire Hospital.

Current Opinion in Gastroenterology
|March 12, 2025
PubMed
Abstract

Insights

Diagnosing Meckel's diverticulum (MD) remains challenging. A combination of imaging and endoscopic techniques, alongside a high index of suspicion, is often required for accurate diagnosis and management.

Area of Science:

  • Gastroenterology
  • Diagnostic Imaging
  • Surgical Management

Background:

  • Meckel's diverticulum (MD) is a common congenital anomaly of the ileum.
  • While often asymptomatic, MD can lead to complications like obstruction, diverticulitis, or bleeding.
  • Accurate diagnosis of MD continues to be a challenge in clinical practice.

Purpose of the Study:

  • To review the gastroenterologist's approach to diagnosing Meckel's diverticulum.
  • To outline current diagnostic strategies and management options for MD.
  • To highlight the diagnostic challenges associated with Meckel's diverticulum.

Main Methods:

  • Review of diagnostic modalities including Meckel's scan, small bowel capsule endoscopy (SBCE), and device-assisted enteroscopy (DAE).
  • Discussion of imaging techniques such as CT scans.
  • Analysis of treatment strategies for symptomatic and asymptomatic MD.

Main Results:

  • Meckel's scan sensitivity ranges from 80-92% in children and 62-88% in adults.
  • Small bowel capsule endoscopy (SBCE) has a diagnostic yield of up to 50%.
  • Device-assisted enteroscopy (DAE) shows high sensitivity (84-100%) but is invasive; surgical resection is definitive for symptomatic MD.

Conclusions:

  • Accurate diagnosis of Meckel's diverticulum often necessitates a multimodality approach combining imaging and endoscopy.
  • Surgical resection is the standard treatment for complicated MD.
  • The management of incidental Meckel's diverticulum is debated, but current evidence suggests favoring resection.

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