Single-balloon Enteroscopy for Diagnosis of Meckel Diverticulum in Adults / 胃肠病学

ABSTRACT

Background: Meckel diverticulum is one of the most common congenital malformations of the gastrointestinal tract. It is relatively rare in adults and is difficult to make a preoperative diagnosis. Aims: To analyze the clinical characteristics of Meckel diverticulum in adults and to investigate the diagnostic value of single-balloon enteroscopy for adult Meckel diverticulum. Methods: A retrospective study was performed in patients diagnosed as adult Meckel diverticulum by single-balloon enteroscopy at Renji Hospital, School of Medicine, Shanghai Jiao Tong University from Apr. 2011 to Jan. 2019. Results: A total of 30 adult Meckel diverticulum patients were enrolled. Of them, 26 were male and 4 were female with a mean age of (36.1±14.6) years. The mean duration of symptoms ranged from 6 days to 30 years. The prevalence of gastrointestinal bleeding, abdominal pain/diarrhea, and anemia was 73.3% (22/30), 40.0% (12/30), and 50.0% (15/30), respectively. All the diverticula were detected by retrograde single-balloon enteroscopy. The mean distance of diverticulum from the ileocecal valve was (98.7±29.5) cm, and the size of diverticulum opening was 3.25 cm on average. Ulcer was found in 11 cases. Sixteen cases underwent surgical resection, and 12.5% and 18.8% of them were proved to contain ectopic gastric mucosa and ectopic pancreas, respectively. The diagnostic yield of capsule endoscopy and imaging modalities were relatively low (39.1% and 20.7%, respectively). Conclusions: Single-balloon enteroscopy has a high diagnostic value for Meckel diverticulum in adults and may provide guidance for clinical treatment. For adults suspected of Meckel diverticulum, retrograde single-balloon enteroscopy is recommended.