The Role of Capsule Endoscopy in Urgent Evaluation of Obscure Gastrointestinal Bleeding: A Case Series of Meckel Diverticulum .

Silva, Marco; Cardoso, Hélder; Peixoto, Armando; Lopes, Susana; Santos, Ana Luísa; Gomes, Sara; Macedo, Guilherme

doi:10.1590/0102-672020180001e1409

Cited by 12 publications

(6 citation statements)

References 9 publications

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“…Regarding modern aspects of diagnostics, capsule endoscopy has been recently introduced as a promising tool for the diagnosis of MD [ 22 ]. However, to date, this technique has only been reported in smaller case series [ 23 , 24 ] and one larger study [ 25 ]. Although performed in 91% of cases with ectopic mucosa, no case of MD was assumed by ultrasound (US).…”

Section: Discussionmentioning

confidence: 99%

Meckel’s Diverticulum in Children: A Monocentric Experience and Mini-Review of Literature

et al. 2022

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Vitelline duct anomalies (VDA, including Meckel’s diverticulum (MD)) result from failed embryologic obliteration. This study aimed for characteristics in symptomatic versus asymptomatic VDA, analyzing clinico-laboratory data from 73 children, aged 1 day to 17 years, treated at a tertiary Pediatric Surgery Institution from 2002–2017. A male preponderance was obtained (ratio 3.6:1). MD accounted for 85% of VDA. Incidence of symptomatic VDA decreased with older age. Leading symptoms were intestinal obstruction and hemorrhage. Mucosal heterotopia (present in 39% of symptomatic MD) was associated with anemia and lowered CRP-levels. On ROC-analysis, hemoglobin < 8.6 g/dL, CRP < 0.6 mg/dL and MD distance to ileocecal valve >40 cm were predictors of ectopic tissue in symptomatic MD. Our data confirmed known characteristics as male preponderance, declined incidence of symptomatic cases with age and predominance of gastric ectopia in symptomatic MD. Moreover, anemia and prolonged distance of MD to ileocecal valve were predictors of ectopic mucosa in symptomatic MD.

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Section: Discussionmentioning

confidence: 99%

Meckel’s Diverticulum in Children: A Monocentric Experience and Mini-Review of Literature

et al. 2022

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“…Diagnosis of Meckel’s diverticulum might be sort of challenging, and traditional diagnostic approaches usually include ultrasonography, CT scan, magnetic resonance imaging (MRI), and Meckel’s ECT, but with relatively low detecting rate, thus in some cases finally leads to diagnostic laparoscopy ( 5 ). Previous small sample pilot studies raised possibility and advantage of capsule endoscopy in identifying bleeding Meckel’s diverticulum when conventional modalities (gastroscopy, colonoscopy, CT and Meckel’s ECT) did not show any lesion, in which cases, either a double-duct sign, with or without bleeding was discovered, indicating capsule endoscopy as an effective and promising modality which can potentially be of added value in the diagnosis, especially bleeding, of Meckel’s diverticulum in the future ( 9 , 10 ). Moreover, in recent years, as development of double balloon enteroscopy, Meckel’s diverticulum would also be helpful, as in our case, specific refined structure could be well observed and even biopsied under enteroscopy was possible, providing a new approach of Meckel’s diverticulum diagnosis and thus raising positive rate of diagnostic laparoscopy.…”

Section: Discussionmentioning

confidence: 99%

Heterotopic pancreas in Meckel’s diverticulum in an adult man with lower gastrointestinal bleeding: a case report and literature review

Chen¹,

Zhang²,

Yu³

et al. 2023

AME Case Rep

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Background Meckel’s diverticulum is a blind-end true diverticulum that contains all of the layers, which is normally found in the ileum. Prevalence of Meckel’s diverticulum is around 2% in the general population, and even rare among adults. Gastrointestinal (GI) bleeding is a common complication of Meckel’s diverticulum in children and in most cases, caused by peptic ulceration, due to ectopic gastric mucosa, while in minority cases, pancreatic tissue would also appear consisting around 6% of all Meckel’s diverticulum patients. Case Description Herein, we reported a 45-year-old man presented with recurrent hematochezia for over one-month without other remarkable symptoms or past medical history or signs on physical examination. Laboratory examinations showed hemoglobin of 114 g/L and ++++ in stool occult blood test without red blood cell. Contrasted abdominopelvic computerized tomography (CT) were normal and Meckel’s electroconvulsive therapy (ECT) for identification was also negative. Considering gastroscopy and colonoscopy were both unremarkable in local hospital, double balloon enteroscopy was adopted and revealed double duct sign at about 100 cm proximal to the ileocecal valve and thus indicated existence of diverticulum. Further, ulceration was found at the far-end bottom of the blind-ending tube. The patient then underwent laparoscopic resection of Meckel’s diverticulum and pathology study showed heterotopic pancreas in Meckel’s diverticulum. The patient started feeding two days after surgery and was discharged on regular out-patient follow-up two weeks later. Till now, no reappear of hematochezia episode was observed. Conclusions Heterotopic pancreas in Meckel’s diverticulum is relative rare clinical condition in adult which can cause recurrent lower GI bleeding. Thus, special attention should be paid in cases with unexplained lower GI bleeding in adult.

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“…Capsule endoscopy and double-balloon endoscopy of the small intestine have recently been reported to be useful for diagnosis of Meckel’s diverticulum, and can be bridging tools in treatment, such as evaluation from the lumen of the digestive tract and lesion marking; however, these are presently available only in a limited number of institutions [8]. In general, scintigraphy using radionuclides is considered to be unsuitable for emergency examinations because it takes time to obtain the required radionuclide and perform a test; however, scintigraphy was a useful supplementary diagnostic method for Meckel’s diverticulum in the present case because 99m Tc was readily available at our hospital and the examination could be performed in a relatively short period of time [7].…”

Section: Discussionmentioning

confidence: 99%

“…Laparoscopic surgery is widely used as a surgical treatment for abdominal diseases [8]. Recently, single-incision laparoscopic surgery has been reported as an even less invasive procedure and is also indicated for diverse conditions [9].…”

Section: Discussionmentioning

confidence: 99%

Single incision laparoscopic surgery (SILS) for Meckel’s diverticulum

Kuramoto

Nakahara

Maeda

et al. 2019

Journal of Surgical Case Reports

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A 65-year-old male patient presented with a chief complaint of abdominal pain. Abdominal computed tomography (CT) showed slight intestinal dilation and obstruction of the upper right quadrant of the small intestine, while ectopic gastric mucosal scintigraphy revealed abnormal accumulation in agreement with the CT-identified structure. The cause of bowel obstruction was diagnosed as Meckel’s diverticulum; the patient was referred for surgery. A small laparotomy was performed with a 35-mm skin incision to the center of the navel. Once a lap disk was attached, a laparoscope was inserted to visualize the abdominal cavity. The small intestine that includes the structure was pulled out from the umbilicus to the outside of the peritoneal cavity and partially resected. On the pathological tissue findings, the patient was diagnosed with Meckel’s diverticulum. We report our experience with single-lap laparoscopic surgery for a case of intestinal obstruction caused by Meckel’s diverticulum and review pertinent literature.

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The Role of Capsule Endoscopy in Urgent Evaluation of Obscure Gastrointestinal Bleeding: A Case Series of Meckel Diverticulum .

Cited by 12 publications

References 9 publications

Meckel’s Diverticulum in Children: A Monocentric Experience and Mini-Review of Literature

Meckel’s Diverticulum in Children: A Monocentric Experience and Mini-Review of Literature

Heterotopic pancreas in Meckel’s diverticulum in an adult man with lower gastrointestinal bleeding: a case report and literature review

Single incision laparoscopic surgery (SILS) for Meckel’s diverticulum

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