Gastrointestinal: Meckel's diverticulum and capsule endoscopy: A bad combination

Abstract

A 65-year-old woman was admitted to our hospital in June 2019 with "recurrent abdominal pain for 20 years and aggravation for 3 days." Physical examination showed slight xiphoid process tenderness, lower abdominal tenderness, mild rebound tenderness, and muscle tension. Laboratory examination revealed 69.5 mg/L of C-reactive protein. Computed tomography scan revealed a pelvic hyperdense foreign body, which made it possible to be wrapped or form abscess (Fig. 1a,b); the small intestine wall of the middle and lower abdomen was thickened and reinforced accompanied by small fluid level (Fig. 1c). Laparotomy inspection indicated that there was about 200-mL turbid exudate in the abdomen; Meckel's diverticulum 20 cm away from the ileocecal junction had a size of about 4 × 5 cm; 60 cm of intestinal segments with lesions and inflammatory edema in the diverticulum were resected by surgery. Postoperative specimens such as one metal capsule-like foreign matter, one jujube nucleus, and multiple stercorolith observed in Meckel's diverticulum were collected (Fig. 2).The patient had repeated abdominal pains for many years, and no obvious abnormalities were found in gastroscopy and colonoscopy. Therefore, the capsule endoscopy was performed in 2012 without noticing whether the capsule endoscope was discharged from the body. In this report, the capsule endoscope was taken out, and Meckel's diverticulum, which caused repeated abdominal pains, was resected. The patients were followed up for 1 year, and no abdominal pain reoccurred.