Format

Send to

Choose Destination
PLoS One. 2016 Sep 14;11(9):e0162615. doi: 10.1371/journal.pone.0162615. eCollection 2016.

Diagnosis of Bleeding Meckel's Diverticulum in Adults.

Author information

1
Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
2
Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea.
3
Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
4
Institute for Digestive Research, Soonchunhyang University College of Medicine, Seoul, Republic of Korea.
5
Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
6
Gang Dong Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Republic of Korea.
7
Ewha Womans University College of Medicine, Seoul, Republic of Korea.
8
Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea.

Abstract

BACKGROUND AND AIMS:

Various modalities have been used to diagnose Meckel's diverticulum (MD) in practice, but with their diagnostic accuracy deemed to be unsatisfactory for clinical practice. Moreover, the usefulness of these modalities has not been evaluated for the diagnosis of bleeding MD in adults, due to the relative rarity of this condition. Therefore, the aim of our multicenter study was to determine the most accurate modality for the preoperative diagnosis of bleeding MD in adults.

METHODS:

We conducted a retrospective analysis of the diagnostic accuracy for small bowel bleeding associated with MD of different modalities in patients ≥18 years old who underwent assessment for MD, with confirmation at the time of explorative surgery. Diagnostic accuracy of the different modalities was evaluated against the diagnosis obtained using technetium-99m pertechnetate scintigraphy (also known as Meckel's scan), considered to be the gold standard for the diagnosis of bleeding MD in pediatrics.

RESULTS:

Thirty-five adults were identified with bleeding in MD over the study period, between 2005 and 2012. Among these patients, only 24 (68.6%) were diagnosed with MD preoperatively. The mean (95% confidence interval) diagnostic accuracy of selected modalities was as follows: Meckel's scan, 21.4% (5.7%-51.2%); capsule endoscopy, 35.7% (14.0%-64.4%); balloon-assisted enteroscopy (BAE), 85.0% (61.1%-96.0%); angiography, 0.0% (0.0%-80.2%); computed tomography, 31.8% (14.7%-54.9%); and small-bowel follow-through, 62.5% (25.9%-90.0%). The diagnostic accuracy was significantly higher for BAE than for Meckel's scan (P = 0.001).

CONCLUSIONS:

Among available diagnostic modalities, BAE provides the highest accuracy for the diagnosis of bleeding MD in adults and, therefore, should be considered as the preferred modality for preoperative diagnosis.

PMID:
27626641
PMCID:
PMC5023169
DOI:
10.1371/journal.pone.0162615
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Public Library of Science Icon for PubMed Central
Loading ...
Support Center