Meckel's diverticulum discovered by capsule endoscopy: a systematic review of case reports

Capsule endoscopy has achieved its place as a diagnostic tool in a clinical setting, especially in the small bowel. The most frequent malformation of the gastrointestinal tract (Meckel's Diverticulum) has therefore been discovered incidentally by capsule endoscopies multiple times. However, it is still not a regular diagnostic modality when the pathology is suspected. In this review of case reports, we aim to evaluate the knowledge and rationales of using capsule endoscopy as a diagnostic tool for Meckel's diverticulum.

We performed a search through Pubmed and Embase to find all publications describing cases of Meckel's diverticulum diagnosed by capsule endoscopy. All data was collected, and a stratification based on age group (adult versus pediatric patients) was performed.

The search resulted in 43 cases of Meckel's diverticulum diagnosed with capsule endoscopy, reported in 33 publications. The majority of the patients were male, with a median age of 20 years, and had an average of three negative investigations performed prior to capsule endoscopy. The three most commonly used investigations were upper and lower endoscopy and Meckel's scan. The most frequent finding on capsule endoscopy was the double lumen sign.

The case reports indicate that capsule endoscopy can and has been used as a diagnostic tool for Meckel Diverticulum going back as far as 2002, with the most common finding being the double lumen sign. But it also highlights that patients too often go through multiple negative investigations before having a capsule endoscopy performed.