Skip Navigation LinksHome > February 2012 - Volume 54 - Issue 2 > Identification of Meckel Diverticulum by Capsule Endoscopy
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Journal of Pediatric Gastroenterology & Nutrition:
doi: 10.1097/MPG.0b013e3182349a1c
Image of the Month

Identification of Meckel Diverticulum by Capsule Endoscopy

Desai, Sonal S.; Alkhouri, Razan; Baker, Susan S.

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Women and Children's Hospital of Buffalo, Digestive Diseases and Nutrition Center, SUNY at Buffalo, Buffalo, NY

Address correspondence and reprint requests to Sonal Desai, MD, Women and Children's Hospital of Buffalo, Digestive Diseases and Nutrition Center, 219 Bryant St, Buffalo, NY 14222 (e-mail: sonaldesaimd@gmail.com,sbaker@upa.chob.edu).

Received 29 April, 2011

Accepted 25 July, 2011

Submissions for the Image of the Month should include high-quality TIF endoscopic images of unusual or informative findings. In addition, 1 or 2 other associated photographs, such as radiological or pathological images, can be submitted. A brief description of no more than 200 words should accompany the images. Submissions are to be made online at www.jpgn.org, and will undergo peer review by members of the NASPGHAN Endoscopy and Procedures Committee, as well as by the Journal.

The authors report no conflicts of interest.

A 5-year-old white boy with a medical history of constipation presented with a 1-day history of painless hematochezia. He had 2 episodes of bright-red blood in his stool with clots. Initial laboratory evaluation was positive for hemoglobin of 7.9, hemoccult-positive stool, and 2 negative Meckel scans after 5-day pretreatment with ranitidine (1). An upper endoscopy and colonoscopy were visually and histologically normal. Capsule endoscopy showing 2 lumens within the ileum was consistent with Meckel diverticulum (MD) (Fig. 1). The patient underwent an exploratory laparoscopy; an MD was found and removed (2). The presence of the enteric wall biopsy showing a layering architecture composed of villiform small intestinal mucosa and gastric oxyntic mucosa with focal ulceration on histological evaluation confirmed an MD. Capsule endoscopy, which is not the conventional method of detecting MD, can aid in identifying MD in patients whose previous evaluations are negative. Definitive treatment for MD is surgical removal in the symptomatic patient.

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REFERENCES

1. Swaniker F, Soldes O, Hirschl RB. The utility of technetium 99m pertechnetate scintigraphy in the evaluation of patients with Meckel's diverticulum. J Pediatr Surg 1999; 34:760–764.

2. Shalaby RY, Soliman SM, Fawy M, et al. Laparscopic management of Meckel's diverticulum in children. J Pediatr Surg 2005;40:562–7.

Copyright 2012 by ESPGHAN and NASPGHAN

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