Takagaki K, Osawa S, Ito T, Iwaizumi M, Hamaya Y, Tsukui H, Furuta T, Wada H, Baba S, Sugimoto K. Inverted Meckel’s diverticulum preoperatively diagnosed using double-balloon enteroscopy. World J Gastroenterol 2016; 22(17): 4416-4420 [PMID: 27158212 DOI: 10.3748/wjg.v22.i17.4416]
Corresponding Author of This Article
Satoshi Osawa, MD, PhD, Department of Endoscopic and Photodynamic Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu 431-3192, Japan. sososawa@hama-med.ac.jp
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Kosuke Takagaki, Tatsuhiro Ito, Moriya Iwaizumi, Yasushi Hamaya, Ken Sugimoto, First Department of Medicine, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan
Satoshi Osawa, Department of Endoscopic and Photodynamic Medicine, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan
Takahisa Furuta, Center for Clinical Research, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan
Hiroe Tsukui, Satoshi Baba, Department of Diagnostic Pathology, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan
Hidetoshi Wada, First Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan
Author contributions: Takagaki K and Osawa S wrote the paper; Iwaizumi M, Hamaya Y, Furuta T and Sugimoto K contributed to the paper design and coordination; Takagaki K, Ito T and Osawa S performed the double-balloon enteroscopy; Wada H performed laparoscopic surgery; Tsukui H and Baba S contributed to the pathological examination.
Informed consent statement: The patient has provided permission to publish this paper, and the identity of the patient has been protected.
Conflict-of-interest statement: The authors declare no conflicts of interest associated with this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Satoshi Osawa, MD, PhD, Department of Endoscopic and Photodynamic Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu 431-3192, Japan. sososawa@hama-med.ac.jp
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Received: December 23, 2015 Peer-review started: December 24, 2015 First decision: January 13, 2016 Revised: January 22, 2016 Accepted: February 22, 2016 Article in press: February 22, 2016 Published online: May 7, 2016 Processing time: 128 Days and 7 Hours
Abstract
An inverted Meckel’s diverticulum is a rare gastrointestinal congenital anomaly that is difficult to diagnose prior to surgery and presents with anemia, abdominal pain, or intussusception. Here, we report the case of 57-year-old men with an inverted Meckel’s diverticulum, who was preoperatively diagnosed using double-balloon enteroscopy. He had repeatedly experienced epigastric pain for 2 mo. Ultrasonography and computed tomography showed intestinal wall thickening in the pelvis. Double-balloon enteroscopy via the anal route was performed for further examination, which demonstrated an approximately 8-cm, sausage-shaped, submucosal tumor located approximately 80 cm proximal to the ileocecal valve. A small depressed erosion was observed at the tip of this lesion. Forceps biopsy revealed heterotopic gastric mucosa. Thus, the patient was diagnosed with an inverted Meckel’s diverticulum, and single-incision laparoscopic surgery was performed. This case suggests that an inverted Meckel’s diverticulum should be considered as a differential diagnosis for a submucosal tumor in the ileum. Balloon-assisted enteroscopy with forceps biopsy facilitate a precise diagnosis of this condition.
Core tip: An inverted Meckel’s diverticulum is a rare congenital anomaly of the gastrointestinal tract which is difficult to diagnose prior to surgery. This case report represents the utility of double-balloon enteroscopy for the precise preoperative diagnosis of an inverted Meckel’s diverticulum.
