Application of small bowel capsule endoscopy in children with Meckel's diverticulum.
Journal
European journal of gastroenterology & hepatology
ISSN: 1473-5687
Titre abrégé: Eur J Gastroenterol Hepatol
Pays: England
ID NLM: 9000874
Informations de publication
Date de publication:
01 Jul 2024
01 Jul 2024
Historique:
medline:
3
6
2024
pubmed:
3
6
2024
entrez:
3
6
2024
Statut:
ppublish
Résumé
Meckel diverticulum (MD) is an important cause of gastrointestinal bleeding in children. Small bowel capsule endoscopy (SBCE) is a first-line examination method applied to patients with obscure gastrointestinal bleeding, but there are few studies on its application in children with MD. This article aims to provide evidence in favor of the auxiliary diagnosis of MD in children by analyzing its characteristics using SBCE. We retrospectively collected the clinical data of patients with suspected MD. A total of 58 children were included in this study. All 58 children presented overt gastrointestinal bleeding (bloody stool or melena). Capsule endoscopy identified protruding lesions in 2 cases, double-lumen changes in 30 cases (all considered as MD), vascular lesions in 7 cases, intestinal mucosal inflammatory lesions in 3 cases, ulcers or erosion in 3 cases, and no obvious abnormalities in SBCE in 12 cases. Both SBCE and technetium-99 scans were performed for 24 cases, 22 of which were diagnosed MD by their combined results, giving a diagnostic coincidence rate of 91.7%. Eight cases were highly suspected as MD but were negative for the technetium-99 scan and positive for SBCE. SBCE has high accuracy in the diagnosis of MD in children, especially when performed in combination with a technetium-99 scan, which can greatly improve the diagnostic rate of MD in children.
Sections du résumé
BACKGROUND
BACKGROUND
Meckel diverticulum (MD) is an important cause of gastrointestinal bleeding in children. Small bowel capsule endoscopy (SBCE) is a first-line examination method applied to patients with obscure gastrointestinal bleeding, but there are few studies on its application in children with MD. This article aims to provide evidence in favor of the auxiliary diagnosis of MD in children by analyzing its characteristics using SBCE.
METHODS
METHODS
We retrospectively collected the clinical data of patients with suspected MD.
RESULTS
RESULTS
A total of 58 children were included in this study. All 58 children presented overt gastrointestinal bleeding (bloody stool or melena). Capsule endoscopy identified protruding lesions in 2 cases, double-lumen changes in 30 cases (all considered as MD), vascular lesions in 7 cases, intestinal mucosal inflammatory lesions in 3 cases, ulcers or erosion in 3 cases, and no obvious abnormalities in SBCE in 12 cases. Both SBCE and technetium-99 scans were performed for 24 cases, 22 of which were diagnosed MD by their combined results, giving a diagnostic coincidence rate of 91.7%. Eight cases were highly suspected as MD but were negative for the technetium-99 scan and positive for SBCE.
CONCLUSION
CONCLUSIONS
SBCE has high accuracy in the diagnosis of MD in children, especially when performed in combination with a technetium-99 scan, which can greatly improve the diagnostic rate of MD in children.
Identifiants
pubmed: 38829942
doi: 10.1097/MEG.0000000000002783
pii: 00042737-202407000-00003
doi:
Substances chimiques
Radiopharmaceuticals
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
845-849Informations de copyright
Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Références
Sagar J, Kumar V, Shah DK. Meckel’s diverticulum: a systematic review. J R Soc Med 2006; 99:501–505.
Lindeman R, Søreide K. The many faces of Meckel’s diverticulum: update on management in incidental and symptomatic patients. Curr Gastroenterol Rep 2020; 22 3.
Enns RA, Hookey L, Armstrong D, Bernstein CN, Heitman SJ, Teshima C, et al. Clinical practice guidelines for the use of video capsule endoscopy. Gastroenterology 2017; 152:497–514.
Hansen C, Søreide K. Systematic review of epidemiology, presentation, and management of Meckel’s diverticulum in the 21st century. Medicine (Baltimore) 2018; 97:e12154.
Rondonotti E, Spada C, Adler S, May A, Despott EJ, Koulaouzidis A, et al. Small-bowel capsule endoscopy and device-assisted enteroscopy for diagnosis and treatment of small-bowel disorders: European Society of Gastrointestinal Endoscopy (ESGE) Technical Review. Endoscopy 2018; 50:423–446.
Krstic SN, Martinov JB, Sokic-Milutinovic AD, Milosavljevic TN, Krstic MN. Capsule endoscopy is useful diagnostic tool for diagnosing Meckel’s diverticulum. Eur J Gastroenterol Hepatol 2016; 28:702–707.
Shimada S, Watanabe T, Nadatani Y, Otani K, Taira K, Hosomi S, et al. Clinical factors associated with positive capsule endoscopy findings in patients with obscure gastrointestinal bleeding: a single-center study. Scand J Gastroenterol 2017; 52:1219–1223.
Le Mouel J, Morvan J, Fumery M, Hakim S, Delcenserie R, Chatelain D, et al. Meckel’s diverticulum on third-generation video capsule endoscopy: intradiverticular ulcer, ectopic gastric mucosa, and active bleeding. Endoscopy 2018; 50 E205–E207.
Trucco I, Guido V, Alvite J, Duffau A, Reyes S, Olano C. Diagnosis of Meckel’s diverticulum at the age of 54 by capsule endoscopy. Endoscopy 2022; 54:E372–E373.
Pastore S, Gortani G, Maschio M, Di Leo G, Ventura A. Two lumens, one diagnosis. J Pediatr 2011; 159:511.
Silva M, Cardoso H, Peixoto A, Lopes S, Santos AL, Gomes S, et al. The role of capsule endoscopy in urgent evaluation of obscure gastrointestinal bleeding: a case series of Meckel diverticulum. Arq Bras Cir Dig 2018; 31:e1409.