Inverted Meckel’s diverticulum mimicking an ulcerated pedunculated polyp: detection by single-balloon enteroscopy

Huang, Tien‐Yu; Liu, Y.-C.; Lee, H.-S.; Chu, Heng-Cheng; Chen, P.-J.; Weng, Jianjun; Fu, Chun‐Kai; Hsu, Kuo–Feng

doi:10.1055/s-0030-1256603

Cited by 13 publications

(11 citation statements)

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“…Adverse events did not occur, but perforation due to endoscopic resection has been reported [9]. Diagnosis of inverted MD is difficult; however, careful observation of the surface pattern of MD and abdominal CT lead to the diagnosis.…”

Section: Discussionmentioning

confidence: 99%

A case series of Meckel’s diverticulum: usefulness of double-balloon enteroscopy for diagnosis

et al. 2014

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BackgroundMeckel’s diverticulum is a congenital anomaly of the gastrointestinal tract. About 98% of affected patients are asymptomatic. Small intestinal examination has become easier since the development of double-balloon enteroscopy. The present case series describes 10 patients with Meckel’s diverticulum in whom double-balloon enteroscopy was useful for diagnosis.Case presentationTen patients (8 men, 2 women) with Meckel’s diverticulum underwent double-balloon enteroscopy at Kobe City Medical Center General Hospital from May 2004 through May 2013. Their median age was 31.5 years (range, 14–83 years). Ten retrograde and two anterograde double-balloon enteroscopy procedures were performed. Double-balloon enteroscopy showed Meckel’s diverticulum in nine patients, but an inverted Meckel’s diverticulum was diagnosed as a lipoma in one patient. Meckel’s diverticulum was detected by iodinated contrast medium during anterograde double-balloon enteroscopy in one of the two patients who underwent this procedure. Meckel’s diverticulum was suspected using capsule endoscopy in one of two patients who underwent this procedure. Abdominal computed tomography was performed in all patients and revealed abnormalities in six, but Meckel’s diverticulum was suspected in only two. Technetium-99 m pertechnetate scintigraphy and a small bowel series were carried out in six patients, revealing Meckel’s diverticulum in one and three patients, respectively. Surgery was performed in eight patients, and endoscopic resection was carried out in one; the remaining patient was transferred to another hospital. Ulcer formation was found in or near Meckel’s diverticulum in eight patients.ConclusionCompared with other modalities, double-balloon enteroscopy is excellent for the diagnosis of Meckel’s diverticulum because direct observation of both Meckel’s diverticulum and ulceration is possible. Double-balloon enteroscopy should be used complementarily to other less invasive examinations when needed to confirm or establish the diagnosis.

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Section: Discussionmentioning

confidence: 99%

A case series of Meckel’s diverticulum: usefulness of double-balloon enteroscopy for diagnosis

et al. 2014

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“…One case had a successful outcome after placement of hemoclips at the base of the resection site, and the other case was complicated by perforation 1,2. There have been reports in the literature of inverted Meckel’s diverticulum diagnosed with balloon-assisted enteroscopy, but only a minority of cases were associated with intussusception 3-6.…”

Section: Case Reportmentioning

confidence: 99%

Inverted Meckel's Diverticulum with Intussusception and Ulceration Diagnosed after Rectal Double-Balloon Enteroscopy

Alshankiti

Halloran

D'Urbano

et al. 2016

ACG Case Reports Journal

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“…DBE offers some advantages over other methods for allowing direct observation of the diverticular ostium, access to the entire small bowel, repeated examinations of the region and intraluminal therapy ( i.e . injection, coagulation)[ 12 , 13 ]. Finding another potential source of bleeding may aid in establishing the correct diagnosis, since MD may coexist with several other lesions.…”

Section: Discussionmentioning

confidence: 99%

“…In our case series, tattooing also aided in locating the affected segment laparoscopically for subsequent resection. DBE may also reveal unusual MD presentations, such as an inverted MD - a rare condition in which the diverticulum is completely inverted intraluminally and mimics a large subepithelial lesion[ 12 ]. Intradiverticular polyps and tumors can be also found through direct visualization inside the MD lumen[ 5 ].…”

Section: Discussionmentioning

confidence: 99%

Balloon-assisted enteroscopy for suspected Meckel’s diverticulum and indefinite diagnostic imaging workup

Gomes

Bonin

Noda

et al. 2016

WJGE

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Meckel’s diverticulum (MD) is estimated to affect 1%-2% of the general population, and it represents a clinically silent finding of a congenital anomaly in up to 85% of the cases. In adults, MD may cause symptoms, such as overt occult lower gastrointestinal bleeding. The diagnostic imaging workup includes computed tomography scan, magnetic resonance imaging enterography, technetium 99m scintigraphy (99mTc) using either labeled red blood cells or pertechnetate (known as the Meckel’s scan) and angiography. The preoperative detection rate of MD in adults is low, and many patients ultimately undergo exploratory laparoscopy. More recently, however, endoscopic identification of MD has been possible with the use of balloon-assisted enteroscopy via direct luminal access, which also provides visualization of the diverticular ostium. The aim of this study was to review the diagnosis by double-balloon enteroscopy of 4 adults with symptomatic MD but who had negative diagnostic imaging workups. These cases indicate that balloon-assisted enteroscopy is a valuable diagnostic method and should be considered in adult patients who have suspected MD and indefinite findings on diagnostic imaging workup, including negative Meckel’s scan.

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Inverted Meckel’s diverticulum mimicking an ulcerated pedunculated polyp: detection by single-balloon enteroscopy

Abstract: UCTN-Unusual cases and technical notes E244 Huang T-Y et al. Inverted Meckel's diverticulum mimicking an ulcerated pedunculated polyp … Endoscopy 2011; 43: E244-E245 This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited.

Cited by 13 publications

References 1 publication

A case series of Meckel’s diverticulum: usefulness of double-balloon enteroscopy for diagnosis

A case series of Meckel’s diverticulum: usefulness of double-balloon enteroscopy for diagnosis

Inverted Meckel's Diverticulum with Intussusception and Ulceration Diagnosed after Rectal Double-Balloon Enteroscopy

Balloon-assisted enteroscopy for suspected Meckel’s diverticulum and indefinite diagnostic imaging workup

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