Bleeding Meckel’s Diverticulum in Children: The Diagnostic Value of Double-Balloon Enteroscopy

Geng, Lan-Lan; Chen, Pei-Yu; Wu, Qiang; Li, Huiwen; Li, Ding‐You; Yang, Min; Gong, Sitang

doi:10.1155/2017/7940851

Cited by 10 publications

(5 citation statements)

References 14 publications

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“…The distances between MD site to ileocecal valve measured by DBE was 60 to 100 cm (mean ± SD=81.0 ± 16.0 cm), while surgery found that the distances were 30 to 100 cm (mean ± SD =71.0 ± 18.5). These findings are consistent to that reported by Geng et al [ 20 ] There is no statistical difference between DBE and surgical measurements. Therefore DBE can accurately locate the MD bleeding sites and reliably provide guidance for surgical treatment of MD bleeding.…”

Section: Discussionsupporting

confidence: 93%

The diagnostic and treatment values of double-balloon enteroscopy in children's Meckel's diverticular bleeding

et al. 2021

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The diagnostic and treatment values and safety of preoperative double-balloon enteroscopy (DBE) for Meckel's diverticula (MD) bleeding in children by retrospective review and analyses. The clinical data were collected and analyzed from 10 cases of children with MD receiving preoperative DBE examination and postoperative pathological confirmation. The diagnostic and treatment values and safety were assessed through the comparison of the DBE results and intra-operative observations and subsequently postoperative pathological results. Total cases are 10, 7 males and 3 females. The male to female ratio is 2.3 to 1. The youngest patient is 3.3 years old and oldest 12.1, the average age is 7.4 ± 3.0. The lowest body weight is 12.6 kg and the average is 32.5 ± 18.9 kg. The hematochezia was the main clinical manifestation in all patients with anemia and moderate to severe anemia were common (9/10, 90%). All patients had and tolerated the DBE procedures via anal route with 100% success rate. There were no observable complications during the examinations and post operations. All patients were diagnosed with MD by DBE. Exploratory laparoscopy and surgical operations were subsequently performed. All surgical samples were confirmed by pathology as bleeding MD. The postoperative follow-ups up to April 2019 (from 3 to 12 months) do not show any bleeding sign. Pathological examinations found ectopic gastric mucosa in 9 patients (90%) and one case had both ectopic gastric mucosa pancreatic tissue (10%). The distance of MD to ileocecal valve was from 60 to 100 cm (average 81.0 ± 16.0 cm) by DBE examinations. Surgery showed similar findings from 30 to 100 cm (average 71.0 ± 18.5) consistently to DBE. There is no statistical significance between 2 methods (Ζ = 1.715, Ρ = .086). DBE examination proves to be a safe method for diagnosing children's MD disease and can reliably determine the bleeding lesions in children's MD, providing valuable guidance for surgical treatment of children's MD bleeding.

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Section: Discussionsupporting

confidence: 93%

The diagnostic and treatment values of double-balloon enteroscopy in children's Meckel's diverticular bleeding

et al. 2021

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“…Gastrointestinal bleeding presenting with bloody stool related to an MD is caused by ulceration of the small bowel due to acid secretion by ectopic mucosa within the diverticulum or rarely from adjacent ileal ulcers secondary to acid secreted in an MD. Bleeding is reported clinically as acute massive hemorrhage, anemia due to chronic bleeding, or self-limiting recurrent episodes (17). Transfusions are uncommonly reported for Meckel's-associated bleeding.…”

Section: Discussionmentioning

confidence: 99%

Symptomatic Meckel's Diverticulum in Pediatric Patients—Case Reports and Systematic Review of the Literature

et al. 2019

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Introduction: Our aim was to highlight the characteristics of pediatric Meckel's diverticulum with a special focus on its complications. Methods: We report a group of seven patients with Meckel's diverticulum and its resection from the Department of Pediatric Surgery between 2012 and 2017. We reviewed all patient records, clinical presentation, and intraoperative findings. The diagnosis was confirmed by surgery and pathology. For a systematic literature review, we used PubMed, Medline and Google Scholar search engines to locate articles containing terms such as Meckel's diverticulum, children, pediatric, complications and symptomatic. We included article reporting on case series in English and German on pediatric patients only. Results: All included patients ( n = 7) were symptomatic. Some patients showed isolated symptoms, and others presented with a combination of symptoms that consisted of abdominal pain, bloody stool or vomiting. The median age of our seven cases was 3.5 years, including 4 male and 3 female patients. Intestinal obstruction was the most common complication; it was seen in 5 out of 7 patients (intussusception in 4 cases, volvulus in 1 case). Ectopic gastric tissue was identified in 3 cases, and inclusion of pancreatic tissue was observed in 1 case. The literature review identified 8 articles for a total of 641 patients aged between 1 day and 17 years and a male:female ratio of 2.6:1. From this group, 528 patients showed clinical symptoms related to Meckel's diverticulum. The most common symptom was abdominal pain and bloody stool. The most common surgical finding in symptomatic patients was intestinal obstruction (41%), followed by intestinal hemorrhage (34%). Complications such as perforation (10%) and diverticulitis (13%) were less frequently reported. Heterotopic tissue was confirmed on histopathology in 53% of all patients enclosing gastric, pancreatic, and both gastric and pancreatic mucosae. In one case, large intestine tissue could be found. Overall, one death was reported. Conclusion: The presented case series and literature review found similar clinical presentations and complications of Meckel's diverticulum in children. Intestinal obstruction and bleeding are more frequent than inflammation in pediatric Meckel's diverticulum. Bowel obstruction is the leading cause for complicated Meckel's diverticulum in patients younger than 12 years.

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“…Retrospective studies involving large populations have demonstrated that double balloon enteroscopy has higher diagnostic accuracy than scintigraphy. In addition, it allows treatment in some cases although it is limited (Geng et al, 2017). However, its disadvantages are that it is technically difficult, it is not available in most endoscopy centers, and optimal imaging cannot be obtained due to blood and bleeding residues accumulated in the lumen during bleeding.…”

Section: Discussionmentioning

confidence: 99%

A case of Meckel’s diverticulum with life-threatening recurrent gastrointestinal bleeding in an adult

Baş¹,

Avcıoğlu²,

Çalışkan³

2021

J Exp Clin Med

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Meckel’s diverticulum is the most common congenital anomaly of the gastrointestinal system. It results from the incomplete closure of the omphalomesenteric canal in intrauterine life. It is mostly diagnosed in childhood with intestinal obstruction and bleeding. It is uncommon and often clinically silent in adults. Also, it is difficult to diagnose the patients with symptomatic Meckel’s diverticulum. We report a 28-year-old male who presented with life-threatening recurrent lower gastrointestinal (GI) bleeding and was operated with the diagnosis of Meckel’s diverticulum with duodenal ulcer.

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Bleeding Meckel’s Diverticulum in Children: The Diagnostic Value of Double-Balloon Enteroscopy

Cited by 10 publications

References 14 publications

The diagnostic and treatment values of double-balloon enteroscopy in children's Meckel's diverticular bleeding

The diagnostic and treatment values of double-balloon enteroscopy in children's Meckel's diverticular bleeding

Symptomatic Meckel's Diverticulum in Pediatric Patients—Case Reports and Systematic Review of the Literature

A case of Meckel’s diverticulum with life-threatening recurrent gastrointestinal bleeding in an adult

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