Small-bowel capsule endoscopy in patients with Meckel’s diverticulum: clinical features, diagnostic workup, and findings. A European multicenter I-CARE study - 18/04/23
Doi : 10.1016/j.gie.2022.12.014
Peter Baltes, MD 1, ⁎ 
, Xavier Dray, MD, PhD 2, Maria Elena Riccioni, MD, PhD 3, Enrique Pérez-Cuadrado-Robles, MD, PhD 4, Evgeny Fedorov, MD, PhD 5, Felix Wiedbrauck, MD 6, Stefania Chetcuti Zammit, MD 7, Sergio Cadoni, MD 8, Mauro Bruno, MD 9, Emanuele Rondonotti, MD, PhD 10, Gabriele Wurm Johansson, MD, PhD 11, Alessandro Mussetto, MD 12, Hanneke Beaumont, MD, PhD 13, Guillaume Perrod, MD, PhD 14, Deirdre McNamara, MD 15, John Plevris, MD, PhD 16, Cristiano Spada, MD, PhD 3, 17, Rolando Pinho, MD 18, Bruno Rosa, MD 19, Nerea Hervas, MD 20, Romain Leenhardt, MD 2, Clelia Marmo, MD 3, Pilar Esteban-Delgado, MD, PhD 4, Ekaterina Ivanova, MD, PhD 5, Martin Keuchel, MD, PhD 1, 21
on behalf
, Xavier Dray, MD, PhD 2, Maria Elena Riccioni, MD, PhD 3, Enrique Pérez-Cuadrado-Robles, MD, PhD 4, Evgeny Fedorov, MD, PhD 5, Felix Wiedbrauck, MD 6, Stefania Chetcuti Zammit, MD 7, Sergio Cadoni, MD 8, Mauro Bruno, MD 9, Emanuele Rondonotti, MD, PhD 10, Gabriele Wurm Johansson, MD, PhD 11, Alessandro Mussetto, MD 12, Hanneke Beaumont, MD, PhD 13, Guillaume Perrod, MD, PhD 14, Deirdre McNamara, MD 15, John Plevris, MD, PhD 16, Cristiano Spada, MD, PhD 3, 17, Rolando Pinho, MD 18, Bruno Rosa, MD 19, Nerea Hervas, MD 20, Romain Leenhardt, MD 2, Clelia Marmo, MD 3, Pilar Esteban-Delgado, MD, PhD 4, Ekaterina Ivanova, MD, PhD 5, Martin Keuchel, MD, PhD 1, 21on behalf
of the International Capsule Endoscopy Research (I-CARE) Meckel study group
Cristina Carretero, Gian Eugenio Tontini, Ervin Toth, Artur Nemeth, Reena Sidhu, Anastasios Koulaouzidis, Abraham Eliakim, Marco Pennazio, Ekaterina Tikhomirova, Hubert Zebski, Chris-Henrik Wulfert, Florentin Stachow, Garrelt Janssen, C. Carretero, E. Tontini, E. Toth
1 Clinic for Internal Medicine, Agaplesion Bethesda Krankenhaus Bergedorf, Hamburg, Germany
2 Sorbonne University, Centre for Digestive Endoscopy, Hospital Saint Antoine, APHP, Paris, France
3 Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Università Cattolica del Sacro Cuore, Roma, Italy
4 Department of Hepato-Gastroenterology, Morales Meseguer Hospital, Murcia, Spain
5 Department of Surgical Gastroenterology and Endoscopy, Moscow University Hospital N31, Pirogov Russia National Research Medical University, Moscow, Russian Federation
6 Department of Gastroenterology, Allgemeines Krankenhaus Celle, Celle, Germany
7 Gastroenterology Department, Sheffield Teaching Hospitals, Sheffield, United Kingdom
8 Digestive Endoscopy Unit, CTO Hospital, Iglesias, Italy
9 University Division of Gastroenterology, University Hospital City of Science and Health Turin, Turin, Italy
10 Gastroenterology Unit, Valduce Hospital, Como, Italy
11 Department of Gastroenterology, Skåne University Hospital, Lund University, Malmö, Sweden
12 Gastroenterology Unit, Santa Maria delle Croci Hospital, Ravenna, Italy
13 Department of Gastroenterology and Hepatology, Amsterdam UMC, location VUmc, Amsterdam, the Netherlands
14 Department of Gastroenterology, Georges Pompidou European Hospital, Paris, France
15 Department of Gastroenterology, Tallaght University Hospital and School of Medicine Trinity College Dublin, Dublin, Ireland
16 Endoscopy Unit, The Royal Infirmary of Edinburgh, University of Edinburgh, Scotland
17 Digestive Endoscopy Unit, Fondazione Poliambulanza, Brescia, Italy
18 Gastroenterology Department, Vila Nova de Gaia/Espinho–Hospital Centre, Vila Nova de Gaia, Portugal
19 Gastroenterology Department, Hospital da Senhora da Oliveira, Guimarães, Portugal
20 Department of Gastroenterology, Complejo Hospitalario Navarra, Pamplona, Spain
21 Clinic for Gastroenterology, Asklepios Klinik Altona, Hamburg, Germany
∗Reprint requests: Peter Baltes, MD, Clinic for Internal Medicine, Agaplesion Bethesda Krankenhaus Bergedorf, Glindersweg 80, 21029 Hamburg, Germany.Clinic for Internal MedicineAgaplesion Bethesda Krankenhaus BergedorfGlindersweg 80Hamburg21029Germany
Abstract |
Background and Aims |
Meckel’s diverticulum (MD) may remain silent or be associated with adverse events such as GI bleeding. The main aim of this study was to evaluate indicative small-bowel capsule endoscopy (SBCE) findings, and the secondary aim was to describe clinical presentation in patients with MD.
Methods |
This retrospective European multicenter study included patients with MD undergoing SBCE from 2001 until July 2021.
Results |
Sixty-nine patients with a confirmed MD were included. Median age was 32 years with a male-to-female ratio of approximately 3:1. GI bleeding or iron-deficiency anemia was present in nearly all patients. Mean hemoglobin was 7.63 ± 1.8 g/dL with a transfusion requirement of 52.2%. Typical capsule endoscopy (CE) findings were double lumen (n = 49 [71%]), visible entrance into the MD (n = 49 [71%]), mucosal webs (n = 30 [43.5%]), and bulges (n = 19 [27.5%]). Two or more of these findings were seen in 48 patients (69.6%). Ulcers were detected in 52.2% of patients (n = 36). In 63.8% of patients (n = 44), a combination of double lumen and visible entrance into the MD was evident, additionally revealing ulcers in 39.1% (n = 27). Mean percent SB (small bowel) transit time for the first indicative image of MD was 57% of the total SB transit time.
Conclusions |
Diagnosis of MD is rare and sometimes challenging, and a preoperative criterion standard does not exist. In SBCE, the most frequent findings were double-lumen sign and visible diverticular entrance, sometimes together with ulcers.
Le texte complet de cet article est disponible en PDF.Abbreviations : CE, DAE, IDA, MD, MRI, SB, SBCE, SSBB
Plan
| Disclosure: The following authors disclosed financial relationships: P. Baltes: Speaker fees from Medtronic; study support from Ankon. X. Dray: Speaker fees from MSD, Pfizer, Medtronic, Bouchara Recordati, FUJIFILM, Alfasigma, and Norgine; consultant for Alfasigma, Norgine, and PENTAX; cofounder of and shareholder in Augmented Endoscopy; training and travel support from Ankon. C. Spada: Consultant fees from Medtronic; advisory board and speaker fees from Norgine; speaker fees from Pentax; study and travel support fees from Ankon; speaker and advisory board fees from Olympus. H. Beaumont: Speaker fees from Medtronic. E. Rondonotti: Speaker honoraria from FUJIFILM; member of FUJIFILM expert group; and Medtronic Co. consulting agreement. R. Leenhardt: Cofounder and shareholder of Augmented Endoscopy; and lecturer for AbbVie. M. Keuchel: Speaker and consultant fees from Medtronic; speaker fees from Olympus; and study support from Ankon. G. Johansson: speaker fees from Medtronic. D. McNamara: Investigator led grant from Medtronic. A. Musetto: Speaker fees from Olympus. J. Plevris: Speaker honorarium, study and travel support from Jinshan OMOM; advisory board, study and travel support from drFalk. |
|
| Collaborators of the International Capsule Endoscopy Research (I-CARE) Meckel group included the following: Cristina Carretero, Clínica Universidad de Navarra, Pamplona, Spain; Gian Eugenio Tontini, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy; Ervin Toth, Department of Gastroenterology, Skåne University Hospital, Lund University, Malmö, Sweden; Artur Nemeth, Department of Gastroenterology, Skåne University Hospital, Lund University, Malmö, Sweden; Reena Sidhu, Academic Department of Gastroenterology, Sheffield Teaching Hospitals, Department of Infection, Immunity and Cardiavascular Diseases, University of Sheffield, United Kingdom; Anastasios Koulaouzidis, Department of Social Medicine & Public Health, Pomeranian Medical University, Szczecin, Poland; Abraham Eliakim, Gastroenterology Department, Sheba Medical Centre, Tel Aviv University, Tel Aviv, Israel; Marco Pennazio, University Division of Gastroenterology, University Hospital City of Science and Health Turin, Turin, Italy; Ekaterina Tikhomirova, Department of Surgical Gastroenterology and Endoscopy, Moscow University Hospital N31, Pirogov Russia National Research Medical University, Moscow, Russian Federation; Hubert Zebski, Praxis für Gastroenterologie, Bremen, Germany; Chris-Henrik Wulfert, Department of General Surgery, Bundeswehrkrankenhaus Hamburg, Hamburg, Germany; Florentin Stachow, Clinic for Internal Medicine, Johanniter-Krankenhaus Geesthacht, Geesthacht, Germany; and Garrelt Janssen, Praxis für Gastroenterologie, MVZ im Johannes-Hospital, Varel, Germany. Disclosures for the collaborators were as follows: C. Carretero: Consultant fees from Medtronic. E. Tontini: Speaker honoraria from PENTAX, Medtronic, and NTC Pharma; consultant fees from NTC Pharma and F. Hoffmann–La Roche Ltd. E. Toth: Medtronic (consultancy and lecture fee), Olympus (consultancy and lecture fee), ANX Robotica (research material), Norgine (research and travel support). |
© 2023
American Society for Gastrointestinal Endoscopy. Publié par Elsevier Masson SAS. Tous droits réservés.
Vol 97 - N° 5
P. 917 - mai 2023 Retour au numéro
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