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Small-bowel capsule endoscopy in patients with Meckel`s diverticulum: clinical features, diagnostic workup, and findings. A European multicenter I-CARE study

Published:December 23, 2022DOI:https://doi.org/10.1016/j.gie.2022.12.014
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      Abstract

      Background and study aim

      Meckel`s Diverticulum (MD) may remain silent or be associated with complications like gastrointestinal (GI) bleeding. The main aim of this study was to evaluate indicative small bowel capsule endoscopy (SBCE) findings and the secondary aim to describe clinical presentation in patients with MD.

      Patients and Methods

      This retrospective European multicenter study included patients with MD undergoing SBCE from 2001 until July 2021.

      Results

      69 patients with a confirmed MD were included. Mean age was 38.9 (± 20.5) years with a male to female ratio of approximately 3:1. GI bleeding or iron deficiency anemia were present in nearly all patients. Mean hemoglobin was 7.63 (± 1.8) g/dl with a transfusion requirement of 52.2%. Typical CE findings were double lumen (n=49; 71%), visible entrance into MD (n=49, 71%), mucosal webs (n=30, 43.5%) and bulges (n=19, 27.5%). Two or more of these findings were seen in 48 patients (69.6%). Ulcers were detected in 52.2% of patients (n=36). In 63.8% of patients (n=44), a combination of double lumen and visible entrance into the MD was evident, additionally revealing ulcers in 39.1% (n=27). Mean percentage SB transit time for first indicative image of MD was 57% of the total SB transit time.

      Conclusion

      Diagnosis of MD is rare and sometimes challenging and a preoperative gold standard does not exist. In SBCE the most frequent findings were double-lumen sign and visible diverticular entrance, sometimes together with ulcers.

      Key words

      List of abbreviations:

      Capsule Endoscopy (CE), Colon Capsule Endoscopy (CCE), Computed Tomography (CT), Device Assisted Enteroscopy (DAE), Esophagogastroduodenoscopy (EGD), Gastrointestinal (GI), Interquartile range (IQR), International CApsule Endoscopy Research (I-CARE), Iron Deficiency Anemia (IDA), Meckel`s Diverticulum (MD), Magnetic Resonance Imaging (MRI), Regional Transit Abnormality (RTA), Standard Deviation (SD), Small Bowel (SB), Small Bowel Capsule Endoscopy (SBCE), Small Bowel Follow Through (SBFT), Suspected Small Bowel Bleeding (SSBB), Ultrasound (US)
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