Meckel's diverticulum other diagnostic studies: Difference between revisions
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==Overview== | ==Overview== | ||
Diagnostic studies such as [[colonoscopy]], double-balloon [[enteroscopy]], [[ | Diagnostic studies such as [[colonoscopy]], double-balloon [[enteroscopy]], [[laparoscopy]], and exploratory [[laparotomy]] may help in the detection of symptomatic and asymptomatic Meckel's diverticula. Screenings for [[bleeding disorder]]s may be performed to rule out other sources of [[bleeding]]. | ||
==Other Diagnostic Studies== | ==Other Diagnostic Studies== | ||
==== Colonoscopy ==== | ==== Colonoscopy ==== | ||
* [[Colonoscopy]] may be helpful in ruling out other sources of [[bleeding]] but is not used as an | * [[Colonoscopy]] may be helpful in ruling out other sources of [[bleeding]] but is not used as an diagnostic tool. | ||
==== Double-balloon enteroscopy ==== | ==== Double-balloon enteroscopy ==== | ||
* [[Double-balloon enteroscopy|Double-balloon enteroscopy (DBE)]] is a potentially useful tool for:<ref name="pmid26059237">{{cite journal |vauthors=Qi S, Huang H, Wei D, Lv C, Yang Y |title=Diagnosis and minimally invasive surgical treatment of bleeding Meckel's diverticulum in children using double-balloon enteroscopy |journal=J. Pediatr. Surg. |volume=50 |issue=9 |pages=1610–2 |year=2015 |pmid=26059237 |doi=10.1016/j.jpedsurg.2015.05.002 |url=}}</ref> | * [[Double-balloon enteroscopy|Double-balloon enteroscopy (DBE)]] is a potentially useful tool for:<ref name="pmid26059237">{{cite journal |vauthors=Qi S, Huang H, Wei D, Lv C, Yang Y |title=Diagnosis and minimally invasive surgical treatment of bleeding Meckel's diverticulum in children using double-balloon enteroscopy |journal=J. Pediatr. Surg. |volume=50 |issue=9 |pages=1610–2 |year=2015 |pmid=26059237 |doi=10.1016/j.jpedsurg.2015.05.002 |url=}}</ref><ref name="pmid23305600">{{cite journal |vauthors=He Q, Zhang YL, Xiao B, Jiang B, Bai Y, Zhi FC |title=Double-balloon enteroscopy for diagnosis of Meckel's diverticulum: comparison with operative findings and capsule endoscopy |journal=Surgery |volume=153 |issue=4 |pages=549–54 |year=2013 |pmid=23305600 |doi=10.1016/j.surg.2012.09.012 |url=}}</ref><ref name="pmid23305600">{{cite journal |vauthors=He Q, Zhang YL, Xiao B, Jiang B, Bai Y, Zhi FC |title=Double-balloon enteroscopy for diagnosis of Meckel's diverticulum: comparison with operative findings and capsule endoscopy |journal=Surgery |volume=153 |issue=4 |pages=549–54 |year=2013 |pmid=23305600 |doi=10.1016/j.surg.2012.09.012 |url=}}</ref><ref name="pmid25175823">{{cite journal |vauthors=Fukushima M, Kawanami C, Inoue S, Okada A, Imai Y, Inokuma T |title=A case series of Meckel's diverticulum: usefulness of double-balloon enteroscopy for diagnosis |journal=BMC Gastroenterol |volume=14 |issue= |pages=155 |year=2014 |pmid=25175823 |pmc=4155089 |doi=10.1186/1471-230X-14-155 |url=}}</ref><ref name="pmid28135732">{{cite journal |vauthors=Konomatsu K, Kuwai T, Yamaguchi T, Imagawa H, Yamaguchi A, Kouno H, Kohno H |title=Endoscopic full-thickness resection for inverted Meckel's diverticulum using double-balloon enteroscopy |journal=Endoscopy |volume=49 |issue=S 01 |pages=E66–E67 |year=2017 |pmid=28135732 |doi=10.1055/s-0042-121008 |url=}}</ref><ref name="pmid28421109">{{cite journal |vauthors=Geng LL, Chen PY, Wu Q, Li HW, Li DY, Yang M, Gong ST |title=Bleeding Meckel's Diverticulum in Children: The Diagnostic Value of Double-Balloon Enteroscopy |journal=Gastroenterol Res Pract |volume=2017 |issue= |pages=7940851 |year=2017 |pmid=28421109 |pmc=5381199 |doi=10.1155/2017/7940851 |url=}}</ref><ref name="pmid16573771">{{cite journal |vauthors=Manner H, May A, Nachbar L, Ell C |title=Push-and-pull enteroscopy using the double-balloon technique (double-balloon enteroscopy) for the diagnosis of Meckel's diverticulum in adult patients with GI bleeding of obscure origin |journal=Am. J. Gastroenterol. |volume=101 |issue=5 |pages=1152–4 |year=2006 |pmid=16573771 |doi=10.1111/j.1572-0241.2006.00558.x |url=}}</ref><ref name="pmid29282383">{{cite journal |vauthors=Kawasaki Y, Shinozaki S, Yano T, Oshiro K, Morimoto M, Kawarai Lefor A, Yamamoto H |title=Intussusception due to an Inverted Meckel's Diverticulum Diagnosed by Double-Balloon Enteroscopy |journal=Case Rep Gastroenterol |volume=11 |issue=3 |pages=632–636 |year=2017 |pmid=29282383 |pmc=5731178 |doi=10.1159/000481161 |url=}}</ref><ref name="pmid28421109">{{cite journal |vauthors=Geng LL, Chen PY, Wu Q, Li HW, Li DY, Yang M, Gong ST |title=Bleeding Meckel's Diverticulum in Children: The Diagnostic Value of Double-Balloon Enteroscopy |journal=Gastroenterol Res Pract |volume=2017 |issue= |pages=7940851 |year=2017 |pmid=28421109 |pmc=5381199 |doi=10.1155/2017/7940851 |url=}}</ref><ref name="pmid28008404">{{cite journal |vauthors=Al-Shankiti S, Halloran B, D'Urbano D, Zepeda-Gómez S |title=Inverted Meckel's Diverticulum with Intussusception and Ulceration Diagnosed after Rectal Double-Balloon Enteroscopy |journal=ACG Case Rep J |volume=3 |issue=4 |pages=e171 |year=2016 |pmid=28008404 |pmc=5171934 |doi=10.14309/crj.2016.144 |url=}}</ref><ref name="pmid27803776">{{cite journal |vauthors=Gomes GF, Bonin EA, Noda RW, Cavazzola LT, Bartholomei TF |title=Balloon-assisted enteroscopy for suspected Meckel's diverticulum and indefinite diagnostic imaging workup |journal=World J Gastrointest Endosc |volume=8 |issue=18 |pages=679–683 |year=2016 |pmid=27803776 |pmc=5067476 |doi=10.4253/wjge.v8.i18.679 |url=}}</ref> | ||
** [[Diagnosis]] | ** [[Diagnosis]] | ||
** As a guide for minimally [[Invasive (medical)|invasive]] treatment | ** As a guide for minimally [[Invasive (medical)|invasive]] treatment | ||
| Line 27: | Line 27: | ||
****[[Mucous membrane|Mucosal]] [[Ulcer|ulceration]] | ****[[Mucous membrane|Mucosal]] [[Ulcer|ulceration]] | ||
****Active [[bleeding]] | ****Active [[bleeding]] | ||
Wireless capsule endoscopy | |||
==== Wireless capsule endoscopy ==== | |||
* May display normal, [[bleeding]], [[Ulcer|ulcerated]] and inverted Meckel's diverticulum<ref name="pmid26854797">{{cite journal |vauthors=Krstic SN, Martinov JB, Sokic-Milutinovic AD, Milosavljevic TN, Krstic MN |title=Capsule endoscopy is useful diagnostic tool for diagnosing Meckel's diverticulum |journal=Eur J Gastroenterol Hepatol |volume=28 |issue=6 |pages=702–7 |year=2016 |pmid=26854797 |doi=10.1097/MEG.0000000000000603 |url=}}</ref><ref name="pmid22008954">{{cite journal |vauthors=Desai SS, Alkhouri R, Baker SS |title=Identification of meckel diverticulum by capsule endoscopy |journal=J. Pediatr. Gastroenterol. Nutr. |volume=54 |issue=2 |pages=161 |year=2012 |pmid=22008954 |doi=10.1097/MPG.0b013e3182349a1c |url=}}</ref><ref name="pmid28372457">{{cite journal |vauthors=Juanmartiñena Fernández JF, Fernández-Urién Sainz I, Saldaña Dueñas C, Iglesias Picazo R |title=Meckel´s diverticulum bleeding detected by capsule endoscopy |journal=Rev Esp Enferm Dig |volume=109 |issue=4 |pages=295–296 |year=2017 |pmid=28372457 |doi= |url=}}</ref> | |||
* May be use to detect cause of [[gastrointestinal bleeding]] of uncertain origin. | |||
==== Laparoscopy and laparotomy ==== | ==== Laparoscopy and laparotomy ==== | ||
* Means by which an incidental Meckel's diverticulum is most commonly detected | * Means by which an incidental Meckel's diverticulum is most commonly detected. | ||
* May be a necessary modality to determine the source of [[bleeding]] if the results on [[diagnostic testing]] are equivocal or in case of hemodynamically unstable patients | * May be a necessary modality to determine the source of [[bleeding]] if the results on [[diagnostic testing]] are equivocal or in case of hemodynamically unstable patients. | ||
==== Screenings for bleeding disorders ==== | ==== Screenings for bleeding disorders ==== | ||
Latest revision as of 19:18, 11 January 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sudarshana Datta, MD [2]
Overview
Diagnostic studies such as colonoscopy, double-balloon enteroscopy, laparoscopy, and exploratory laparotomy may help in the detection of symptomatic and asymptomatic Meckel's diverticula. Screenings for bleeding disorders may be performed to rule out other sources of bleeding.
Other Diagnostic Studies
Colonoscopy
- Colonoscopy may be helpful in ruling out other sources of bleeding but is not used as an diagnostic tool.
Double-balloon enteroscopy
- Double-balloon enteroscopy (DBE) is a potentially useful tool for:[1][2][2][3][4][5][6][7][5][8][9]
- In adults, DBE and Meckel’s scan have been found to have a comparable diagnostic accuracy.
- Types of DBE:
- Prograde (per os)
- Retrograde (per rectum)
- Use of DBE:
- Confirmation of the diagnosis of Meckel's diverticulum based on suspicion from imaging studies such as CT, Meckel's scan
- Evaluation of the distal small bowel directly in patients with equivocal findings
- Endoscopy
- Confirmation of the diagnosis by direct vision
- Detection of complications:
- Mucosal ulceration
- Active bleeding
Wireless capsule endoscopy
- May display normal, bleeding, ulcerated and inverted Meckel's diverticulum[10][11][12]
- May be use to detect cause of gastrointestinal bleeding of uncertain origin.
Laparoscopy and laparotomy
- Means by which an incidental Meckel's diverticulum is most commonly detected.
- May be a necessary modality to determine the source of bleeding if the results on diagnostic testing are equivocal or in case of hemodynamically unstable patients.
Screenings for bleeding disorders
- It is necessary to screen for bleeding disorders to rule out other causes of GI bleeding.
References
- ↑ Qi S, Huang H, Wei D, Lv C, Yang Y (2015). "Diagnosis and minimally invasive surgical treatment of bleeding Meckel's diverticulum in children using double-balloon enteroscopy". J. Pediatr. Surg. 50 (9): 1610–2. doi:10.1016/j.jpedsurg.2015.05.002. PMID 26059237.
- ↑ 2.0 2.1 He Q, Zhang YL, Xiao B, Jiang B, Bai Y, Zhi FC (2013). "Double-balloon enteroscopy for diagnosis of Meckel's diverticulum: comparison with operative findings and capsule endoscopy". Surgery. 153 (4): 549–54. doi:10.1016/j.surg.2012.09.012. PMID 23305600.
- ↑ Fukushima M, Kawanami C, Inoue S, Okada A, Imai Y, Inokuma T (2014). "A case series of Meckel's diverticulum: usefulness of double-balloon enteroscopy for diagnosis". BMC Gastroenterol. 14: 155. doi:10.1186/1471-230X-14-155. PMC 4155089. PMID 25175823.
- ↑ Konomatsu K, Kuwai T, Yamaguchi T, Imagawa H, Yamaguchi A, Kouno H, Kohno H (2017). "Endoscopic full-thickness resection for inverted Meckel's diverticulum using double-balloon enteroscopy". Endoscopy. 49 (S 01): E66–E67. doi:10.1055/s-0042-121008. PMID 28135732.
- ↑ 5.0 5.1 Geng LL, Chen PY, Wu Q, Li HW, Li DY, Yang M, Gong ST (2017). "Bleeding Meckel's Diverticulum in Children: The Diagnostic Value of Double-Balloon Enteroscopy". Gastroenterol Res Pract. 2017: 7940851. doi:10.1155/2017/7940851. PMC 5381199. PMID 28421109.
- ↑ Manner H, May A, Nachbar L, Ell C (2006). "Push-and-pull enteroscopy using the double-balloon technique (double-balloon enteroscopy) for the diagnosis of Meckel's diverticulum in adult patients with GI bleeding of obscure origin". Am. J. Gastroenterol. 101 (5): 1152–4. doi:10.1111/j.1572-0241.2006.00558.x. PMID 16573771.
- ↑ Kawasaki Y, Shinozaki S, Yano T, Oshiro K, Morimoto M, Kawarai Lefor A, Yamamoto H (2017). "Intussusception due to an Inverted Meckel's Diverticulum Diagnosed by Double-Balloon Enteroscopy". Case Rep Gastroenterol. 11 (3): 632–636. doi:10.1159/000481161. PMC 5731178. PMID 29282383.
- ↑ Al-Shankiti S, Halloran B, D'Urbano D, Zepeda-Gómez S (2016). "Inverted Meckel's Diverticulum with Intussusception and Ulceration Diagnosed after Rectal Double-Balloon Enteroscopy". ACG Case Rep J. 3 (4): e171. doi:10.14309/crj.2016.144. PMC 5171934. PMID 28008404.
- ↑ Gomes GF, Bonin EA, Noda RW, Cavazzola LT, Bartholomei TF (2016). "Balloon-assisted enteroscopy for suspected Meckel's diverticulum and indefinite diagnostic imaging workup". World J Gastrointest Endosc. 8 (18): 679–683. doi:10.4253/wjge.v8.i18.679. PMC 5067476. PMID 27803776.
- ↑ Krstic SN, Martinov JB, Sokic-Milutinovic AD, Milosavljevic TN, Krstic MN (2016). "Capsule endoscopy is useful diagnostic tool for diagnosing Meckel's diverticulum". Eur J Gastroenterol Hepatol. 28 (6): 702–7. doi:10.1097/MEG.0000000000000603. PMID 26854797.
- ↑ Desai SS, Alkhouri R, Baker SS (2012). "Identification of meckel diverticulum by capsule endoscopy". J. Pediatr. Gastroenterol. Nutr. 54 (2): 161. doi:10.1097/MPG.0b013e3182349a1c. PMID 22008954.
- ↑ Juanmartiñena Fernández JF, Fernández-Urién Sainz I, Saldaña Dueñas C, Iglesias Picazo R (2017). "Meckel´s diverticulum bleeding detected by capsule endoscopy". Rev Esp Enferm Dig. 109 (4): 295–296. PMID 28372457.