Published online Oct 16, 2016. doi: 10.4253/wjge.v8.i18.679
Peer-review started: April 27, 2016
First decision: June 12, 2016
Revised: July 13, 2016
Accepted: August 27, 2016
Article in press: August 29, 2016
Published online: October 16, 2016
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.
Core tip: Meckel’s diverticulum (MD) is estimated to affect 1%-2% of the general population and has 4%-6% risk of causing symptoms during a lifetime. In adults, it may cause occult massive bleeding and the preoperative detection rate is low; patients with undiagnosed MD 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, providing visualization of the diverticular ostium. We report here the use of double-balloon enteroscopy for diagnosing 4 adults with symptomatic MD who had negative diagnostic imaging workup.