Lin Lin, Liu Kuiliang, Liu Hong, Wu Jing, Zhang Yaopeng
a Department of Gastroenterology , Beijing Shijitan Hospital Affliated to the Capital Medical University , Beijing , PR China.
b Department of Gastroenterology , Peking University Third Hospital , Beijing , PR China.
Scand J Gastroenterol. 2019 Jan;54(1):122-127. doi: 10.1080/00365521.2018.1553353. Epub 2019 Jan 13.
We described a case series of patients diagnosed with Meckel's diverticulum using capsule endoscopy (CE), reviewed the literature, and aimed to reveal the common CE characteristics of Meckel's diverticulum.
We reviewed a case series of Meckel's diverticulum in the Department of Gastroenterology, Beijing Shijitan Hospital Affliated to the Capital Medical University. In each case, primary upper endoscopy and colonoscopy failed to reveal a reason to explain the complaints (hematochezia in three cases and abdominal pain in one). CE (Pillcam SB2, Given Imaging, Yoqneam, Israel) was chosen as the next diagnostic test of choice and Meckel's diverticulum was detected by CE. Then, endoscopic characteristics and follow-up of Meckel's diverticulum were analyzed.
4 patients were enrolled. CE revealed Meckel's diverticulum in patients with different features. In case 1, CE revealed a typically double lumen sign and diaphragm sign, with visible blood. In case 2 and case 3, CE revealed a protruding lesion with/without erosion. In case 4, CE revealed multiple caved lesions, double lumen sign and capsule retention in an abnormal blind end for over 2 hours.
Except double lumen sign, partial disappearance of normal mucosa and capsule retention, other CE findings could be used for the diagnosis of Meckel's diverticulum, such as protruding lesion, caved lesion, solitary polyp and stenosing lesion.
我们描述了一系列经胶囊内镜(CE)诊断为梅克尔憩室的病例,回顾了相关文献,旨在揭示梅克尔憩室常见的CE特征。
我们回顾了首都医科大学附属北京世纪坛医院消化内科的一系列梅克尔憩室病例。在每例病例中,初次上消化道内镜检查和结肠镜检查均未能发现可解释患者症状的原因(3例便血,1例腹痛)。选择CE(以色列Given Imaging公司的Pillcam SB2)作为下一步的诊断检查,通过CE检测到梅克尔憩室。然后,分析梅克尔憩室的内镜特征及随访情况。
纳入4例患者。CE在不同特征的患者中均发现了梅克尔憩室。病例1中,CE显示典型的双腔征和隔膜征,可见血迹。病例2和病例3中,CE显示有/无糜烂的突出病变。病例4中,CE显示多个凹陷性病变、双腔征以及胶囊在异常盲端滞留超过2小时。
除双腔征、正常黏膜部分消失和胶囊滞留外,其他CE表现如突出病变、凹陷性病变、孤立性息肉和狭窄性病变等均可用于梅克尔憩室的诊断。