Gastrointestinal Bleeding Caused by Meckel’s Diverticulum Diagnosed by Double Balloon Enteroscopy: Three Cases and a Brief Literature Review
Gastrointestinal Bleeding Caused by Meckel’s Diverticulum Diagnosed by Double Balloon Enteroscopy: Three Cases and a Brief Literature Review
AbstractMeckel's diverticulum is a small bulge in the small intestine present at birth and is the most frequent malformation of the gastrointestinal tract. Although Meckel diverticulum is usually of no medical significance, a tendency to gastrointestinal bleeding can require clinical attention. Despite the availability of modern imaging techniques, diagnosis is still challenging. We herein report three cases of undiagnosed gastrointestinal bleeding despite use of a number of imaging techniques. In all of these cases, double balloon enteroscopy was successfully used and the diagnosis of Meckel’s diverticulum was established. We discuss the use of this successful technique in obscure gastrointestinal (GI) bleeding caused by Meckel's diverticulum in relation to the pertinent literature. Key Words: Gastrointestinal Bleeding, Meckel’s Diverticulum, Double Balloon Endoscopy
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- References
- Aubrey DA. Meckel’s diverticulum: a review of the sixtysix emergency Meckel’s diverti culectomies. Arch Surg. 1970;100(2):144-6.
- Weinstein EC, Cain JC, ReMineWH. Meckel’s diverticulum: 55 years of clinical and surgical experience. J Am Med Assoc. 1962;182:131-3.
- Tanaka S, Orita K, Kunimai T et al. A Meckel diverticulum. Statistical consideration of 444 examples; in Japanese. Geka Tiryo. 1971;13:818-26.
- Yamamoto H, Sekine Y, Sato Y, Higashizawa T, Miyata T, Iino S, Ido K, Sugano K. Total enteroscopy with a nonsurgical steerable double-balloon method. Gastrointest Endosc. 2001;53(2):216-20.
- Meckel JF. Über die Divertikel am Darmkanal. Arch Physiol. 1809;9:421-53.
- Mackey WC, Dineen P. A fifty year experience with Meckel’s diverticulum. Surg Gynecol Obstet. 1983;156(1):56-64.
- Berman EJ, Schnider A, PottsWJ. Importance of gastric mucosa in Meckel’s diverticulum. J Am Med Assoc. 1954;156(1):6-7.
- Gasbarrini A, Di Caro S, Mutignani M, Cammarota G, Fini L, Pacelli F, Pola P, Doglietto G, Costamagna G, Gasbarrini G. Double-balloon enteroscopy for diagnosis of a Meckel's diverticulum in a patient with GI bleeding of obscure origin. Gastrointest Endosc. 2005 May;61(6):779-81.
- Park JH, Sohn CI. A case of Meckel's diverticulum diagnosed by double balloon enteroscopy. Korean J Gastroenterol. 2006;47(1):1-4.
- Manner H, May A, Nachbar L, Ell C. 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. 2006;101(5):1152-4.
- Honda K, Mizutani T, Higuchi N, Kanayama K, Sumida Y, Yoshinaga S, Itaba S, Akiho H, Yoshimura R, Nakamura K, Ueki T, Miyasaka Y, Takayanagi R. A Meckel's diverticulum with an ileal ulcer detected with double-balloon enteroscopy. Endoscopy. 2007;39 Suppl 1:E160.
- Ohnita K, Isomoto H, Mizuta Y, Akazawa S, Akazawa Y, Ohba K, Yoshimura M, Shikuwa S, Omagari K, Fujita F, Abe K, Kohno S. Meckel's diverticulum diagnosed by double-balloon enteroscopy. Endoscopy. 2007;39 Suppl 1:E146-7.
- Pasha SF, Leighton JA, Decker GA. Meckel's diverticulum diagnosed by double-balloon enteroscopy. Clin Gastroenterol Hepatol. 2007;5(10):A32.
- Suzuki T, Matsushima M, Okita I, Ito H, Gocho S, Tajima H, Tokiwa K, Teraoka H, Watanabe K, Shirai T, Mine T. Clinical utility of double-balloon enteroscopy for small intestinal bleeding. Dig Dis Sci. 2007;52(8):1914-8.
- Gutierrez C, Mariano M, Vander Laan T, Wang A, Faddis DM, Stain SC. The use of technetium-labeled erythrocyte scintigraphy in the evaluation and treatment of lower gastrointestinal hemorrhage. Am Surg. 1998;64(10):989-92.
- Zuckier LS. Acute gastrointestinal bleeding. Semin Nucl Med. 2003;33(4):297-311.
- Zuckerman GR, Prakash C. Acute lower intestinal bleeding: part I: clinical presentation and diagnosis. Gastrointest Endosc. 1998;48(6):606-17.
- Yamamoto H, Kita H, Sunada K, Hayashi Y, Sato H, Yano T, Iwamoto M, Sekine Y, Miyata T, Kuno A, Ajibe H, Ido K, Sugano K. Clinical outcomes of double-balloon endoscopy for the diagnosis and treatment of small-intestinal diseases. Clin Gastroenterol Hepatol. 2004;2(11):1010-6.
- Kita H, Yamamoto H. Double-balloon endoscopy for the diagnosis and treatment of small intestinal disease. Best Pract Res Clin Gastroenterol. 2006;20(1):179-94.
- Yamamoto H, Kita H. Double-balloon endoscopy. Curr Opin Gastroenterol. 2005;21(5):573-7.