Meckel's diverticulum

Brown, Charles K.; Olshaker, Jonathan S.

doi:10.1016/0735-6757(88)90055-1

Cited by 44 publications

(30 citation statements)

References 28 publications

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“…Imaging with technetium-99 radionuclide scanning or angiography is usually performed in patients with active bleeding, and it has limited value for patients with OGIB [25, 26]. Meckel’s scan, using 99m Tc-pertechnetate which binds to parietal cells, is another nuclear scan for evaluating small bowel bleeding [27]. Angiography for small intestinal angio-ectasias has an especially low yield since angiographic interpretation is more difficult within the small bowel mesenteric arteriolar arcades [28,29,30].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Yield of Capsule Endoscopy in Obscure Gastrointestinal Bleeding

Fireman

Friedman²

2004

Digestion

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Objectives:Chronic occult blood loss from the gastrointestinal tract is a recognized major cause of iron-deficiency anemia. After conventional investigation of the upper and lower parts of the gastrointestinal tract, the source of bleeding remains unidentified in ~10% of these patients. We evaluated the diagnostic yield of capsule endoscopy from patients enrolled in clinical studies due to persistent or recurrent iron-deficiency anemia. Methods: In this large cohort study, patients with obscure gastrointestinal bleeding were identified in a company-sponsored clinical study (Given Imaging, Ltd.) database which contains data from >50 clinical studies. Information on suitable patients was derived from 31 of them. Each subject swallowed an M2A^® Given Capsule containing a miniature video camera, batteries, a transmitter and an antenna. Recording time was ~8 h. The capsule was excreted naturally in the patient’s bowel movement, and the data it transmitted were retrieved and interpreted the next day. Results: 293 patients were studied (135 males, 46.1%, mean age 59.4 ± 16.8 years) whose mean number of bleeding episodes was 4.3 ± 5.5 and mean hemoglobin level was 9.8 ± 2.4 g/dl. The average number of diagnostic procedures per patient prior to the capsule endoscopy study was 5.59. Capsule endoscopy detected definitive findings in 213/293 patients (72%) and findings missed by other diagnostic procedures in 22/293 patients (8%). Neither capsule endoscopy nor the other diagnostic procedures yielded diagnoses in 58/293 patients (20%). Conclusions: Capsule endoscopy has a high diagnostic yield in evaluating patients with obscure gastrointestinal bleeding.

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Section: Discussionmentioning

confidence: 99%

Diagnostic Yield of Capsule Endoscopy in Obscure Gastrointestinal Bleeding

Fireman

Friedman²

2004

Digestion

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“…In our series, all of the patients had such symptoms. In the great majority, it is not even suspected prior to laparotomy, particularly when the adult patients present with pain of acute onset due to obstruction, inflammation, or perforation [11,12]. It is very difficult to make the diagnosis of Meckel's diverticulum preoperatively.…”

Section: Discussionmentioning

confidence: 99%

Angiographic findings of Meckel's diverticulum: The characteristic appearance of the vitelline artery

et al. 1993

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Angiographic findings of the vitelline artery in five patients with surgically proven Meckel's diverticulum were reviewed retrospectively. Superselective vitelline arteriography was performed in two patients and superior mesenteric arteriography in three. Arteriography showed the elongated artery without branching originating from the distal ileal artery and a group of tortuous vessels at the distal portion of this artery in all patients. A dense capillary staining of the vitelline artery was exclusively shown in patients with ectopic gastric mucosa. In one patient, injection of methylene blue intraoperatively through a previously placed angiographic catheter into the vitelline artery stained only the vitelline artery and Meckel's diverticulum in blue but neither the mesentery nor the ileum. Demonstration of a nonbranching artery from the ileal artery and a group of dilated tortuous vessels at the distal portion of this artery should suggest the possibility of Meckel's diverticulum and can be confirmed by selective injection of the artery. It should be emphasized that angiography can detect Meckel's diverticulum even in the absence of acute bleeding.

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“…7,12 Age, the amount of gastric mucosa, the length and width of Meckel's diverticulum, and the presence of mesodiverticular bands seem to be the determining factors in the likelihood of symptoms developing. 4,13,14 Technetium-99m pertechnetate is selectively accumulated and subsequently excreted into the bowel lumen by the mucoid surface cells of the gastric mucosa. 15 The accumulation of detectable amounts of technetium-99m pertechnetate is dependent on adequate blood flow to the mucosa, the size of the mucosal area and its excretory capability.…”

Section: Discussionmentioning

confidence: 99%

A case of intermittent bleeding Meckel’s diverticulum

et al. 1990

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The initial technetium-99m pertechnetate abdominal scintigraphy revealed equivocal or normal results. However, a second scintigraphy without pentagastrin demonstrated a focal area of persistently increasing radioactivity in the right lower quadrant of the abdomen. At surgery, Meckel's diverticulum was confirmed, and histological examination of the excised specimen revealed that it was lined with ectopic gastric mucosa. It has not been satisfactorily explained why the initial imaging failed to demonstrate the ectopic gastric mucosa. The necessity to perform repeated scintigraphy must be emphasized because 50 to 91 percent of bleeding Meckel's diverticula in the pediatric age group are said to contain gastric mucosa.

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Meckel's diverticulum

Cited by 44 publications

References 28 publications

Diagnostic Yield of Capsule Endoscopy in Obscure Gastrointestinal Bleeding

Diagnostic Yield of Capsule Endoscopy in Obscure Gastrointestinal Bleeding

Angiographic findings of Meckel's diverticulum: The characteristic appearance of the vitelline artery

A case of intermittent bleeding Meckel’s diverticulum

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