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

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 x(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. (Surgery 2013;153:549-54.)