Endoscopic characteristics of Meckel’s diverticulum in adults: a retrospective case-series from two tertiary general hospitals in China

Abstract

Background

To analyze the diversity in endoscopic manifestations of Meckel’s diverticulum (MD) in adults by using balloon-assisted enteroscopy (BAE) and supply more information on the application of BAE.

Methods

A retrospective study was carried out on adult patients diagnosed with MD by BAE in two tertiary general hospitals in China, from May 2007 to September 2021. The patients were divided into a small bowel bleeding (SBB) group and a control group according to their main symptoms. Clinical charts and endoscopic images were reviewed, analyzed, and summarized.

Results

Single diverticulum in the ileum and double-lumen sign were observed in all patients. The SBB group consisted of 51 patients, among which 35 cases of ulcerative lesions, 9 cases of erosive lesions, 9 cases of active bleeding/blood clots, and 4 cases of lumps inside the diverticulum were observed respectively. Majority of ulcerative lesions were inside the diverticulum (23/35). A circumferential stricture inside the diverticulum was discovered in 11 cases, and ulcerative lesions tended to occur at this structure (10/11). In the control group consisting of 15 patients, 1 case of erosive lesions at the orifice edge was observed. The percentage of patients with MD-associated ulcerative lesions was significantly higher in the SBB group than that in the control group (p < 0.001).

Conclusions

The endoscopic manifestations of MD in adults are extraordinarily complex and connected with the patients’ primary symptoms. The internal features of MD should be regarded as crucial observational objectives in adult patients.

Keywords:

• Meckel’s diverticulum
• endoscopic characteristics
• balloon-assisted enteroscopy

Acknowledgments

We sincerely thank the pathology and general surgery teams at the two medical centers and appreciate their contributions to this study.

Author contributions

JY and ZC contributed equally to this article. HZ and SN designed the research. JY, LZ, XJ, and SN performed the research. JY, ZC, YF, QT and XY analyzed the data. JY, ZC, and HZ wrote the paper. All authors contributed toward data analysis, drafting and critically revising the paper and agreed to be accountable for all aspects of the work. All authors reviewed and approved the final draft of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was supported by The Ministry of Education Doctoral Fund [20130142120096], and The Wuhan City Health Bureau Project [WX13A07].