Specific characteristics of hemorrhagic Meckel’s diverticulum at double-balloon endoscopy

Abstract

Background and study aims Diagnosis of Meckel’s diverticulum (MD) before surgery may be challenging; double-balloon endoscopy (DBE) facilitates identification of MD in the setting of a gastrointestinal bleeding; however, MD can be found incidentally without this condition. The purpose of this research was to determine specific characteristic of hemorrhagic MD and incidental MD at DBE. Patients and methods Ectopic gastric mucosa enclosed in the MD and/or ulceration were defined as “major findings”; ring-like scar surrounding the MD was defined as “minor finding”. We retrospectively reviewed the medical records of patients affected by MD and analyzed the findings that significantly affected the characterization of MD. Results MD was diagnosed in 33 patients. The axis of the diverticulum was longer in hemorrhagic MD compared to incidental MD (P = 0.031). The amount of transfusion was significantly higher (P = 0.018) in the hemorrhagic MD group. Hemorrhagic MD was significantly more correlated with major findings (P = 0.01) and minor findings (P < 0.01). The specificity of major finding was 100 % while the sensitivity of major and/or minor findings was 96 %. Conclusions The combination of major and minor findings appears to improve the diagnostic ability of hemorrhagic MD avoiding unnecessary diverticulectomy.

Meckel’s diverticulum with polypoid hyperplasia of ectopic gastric mucosa diagnosed by double-balloon enteroscopy and single-photon emission computed tomography/computed tomography

“…After identifying ectopic gastric mucosa, ulceration and a ring-like scar appearance can improve diagnostic confidence in cases of haemorrhagic MD. 18 A diagnosis of MD was made in our case because DBE showed a double lumen and polypoid hyperplasia of ectopic gastric mucosa in the diverticulum. When MD is inverted into the ileum, it may present as an intraluminal polypoid lesion.…”

“… 14 With improvements in the double-balloon endoscopy (DBE) technique, DBE is considered to be a safe and dependable procedure for diagnosing MD in children as well as adults because MD can be directly observed. 15 – 18 In this report, we describe a rare case of MD with polypoid hyperplasia of ectopic gastric mucosa that was diagnosed using a combination of DBE and 99m-technetium pertechnetate with SPECT/CT.…”

Metachronous Krukenberg tumor from adenocarcinoma in a Meckel’s diverticulum: a case report

“…Previous reports demonstrate that tumors in Meckel’s diverticula were most often diagnosed after resection [ 7 ]. Double-ballon enteroscopy has been reported to be useful in patients undergoing evaluation for bleeding from Meckel’s diverticula [ 9 ]. Enteroscopy can allow diagnosis of the disease by direct vision, as well as facilitating biopsy of the lesion and, in some cases, treatment [ 9 , 10 ].…”

“…Double-ballon enteroscopy has been reported to be useful in patients undergoing evaluation for bleeding from Meckel’s diverticula [ 9 ]. Enteroscopy can allow diagnosis of the disease by direct vision, as well as facilitating biopsy of the lesion and, in some cases, treatment [ 9 , 10 ]. In the present patient, we suspected a tumor arising in a Meckel’s diverticulum based on the CT scan findings and performed double-ballon enteroscopy.…”