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Double-balloon enteroscopy for diagnosis of Meckel's diverticulum: comparison with operative findings and capsule endoscopy.

Surgery 2013 April
BACKGROUND: Meckel's diverticulum (MD) is one of the most common congenital gastrointestinal malformations. It is difficult to make a preoperative diagnosis of MD. To date, few data are available describing the diagnosis of MD by double-balloon enteroscopy (DBE) and capsule endoscopy (CE).

METHODS: To assess the value of DBE in the diagnosis of MD and comparatively evaluate the diagnostic yield of DBE and CE for MD. A single-center study was performed on patients with a confirmed diagnosis of MD by surgery and postoperative pathology between January 2003 and December 2011.

RESULTS: Seventy-four patients (60 males) with a mean age of 29.0 ± 14.3 years were analyzed; 33 (55.0%) were between 21 and 40 years of age. Gastrointestinal bleeding was the major finding in 86.5% of the patients who were referred for DBE or CE examination. The mean duration of symptoms was 32.3 ± 48.7 months. In the 74 patients, the diagnostic yield of DBE for MD before surgery was 86.5% (64/74), and correct diagnoses were made in the majority of cases by retrograde DBE, with a few cases by antegrade DBE. In the 26 patients undergoing CE before DBE, the overall diagnostic yield of DBE was 84.6%, significantly greater than that of CE (7.7%, P < .000, McNemar's χ(2) test). Poor agreement was found between the 2 modalities (kappa = 0.03).

CONCLUSION: For patients who are highly suspected of having MD, DBE provides a safe, effective, and reliable means of diagnosis before surgery.

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