Single-center retrospective study of the diagnostic value of doubleballoon enteroscopy in Meckel’s diverticulum with bleeding  

作　　者：Tian He Chao Yang Jing Wang Ji-Sheng Zhong Ai-Hua Li Ya-Jing Yin Li-Ling Luo Chun-Mei Rao Nian-Fen Mao Qiang Guo Zan Zuo Wen Zhang Ping Wan 

机构地区：[1]Yunnan Digestive Endoscopy Clinical Medical Center,Department of Gastroenterology,The First People’s Hospital of Yunnan Province,The Affiliated Hospital of Kunming University of Science and Technology,Kunming 650032,Yunnan Province,China [2]Department of Medicine,Kunming University of Science and Technology,Kunming 650093,Yunnan Province,China [3]School of Medicine,Yunnan University of Traditional Chinese Medicine,Kunming 650011,Yunnan Province,China [4]Department of Gastroenterology,Qujing Hospital of Traditional Chinese Medicine,Qujing 655000,Yunnan Province,China [5]Department of Gastroenterology,Yunnan University of Traditional Chinese Medicine,Kunming 650011,Yunnan Province,China

出　　处：《World Journal of Gastrointestinal Surgery》2024年第4期1043-1054,共12页世界胃肠外科杂志（英文版）（电子版）

基　　金：Supported by the Ten Thousand Doctor Plan in Yunnan Province,No.YNWR-MY-2018-020;Yunnan Digestive Endoscopy Clinical Medical Center Foundation for Health Commission of Yunnan Province,No.2021LCZXXF-XH07,No.2021LCZXXF-XH15,and No.2022LCZXKF-XH17;Yunnan Provincial Key Laboratory of Clinical Virology,No.202205AG070053-07.

摘　　要：BACKGROUND The study aimed to analyze the characteristic clinical manifestations of patients with intestinal disease Meckel’s diverticulum(MD)complicated by digestive tract hemorrhage.Moreover,we aimed to evaluate the value of double-balloon enteroscopy(DBE)in MD diagnosis and the prognosis after laparoscopic diverticula resection.AIM To evaluate the value of DBE in the diagnosis and the prognosis after laparoscopic diverticula resection for MD with bleeding.METHODS The study retrospectively analyzed relevant data from 84 MD patients treated between January 2015 and March 2022 and recorded their clinical manifestations,auxiliary examination,and follow-up after laparoscopic resection of diverticula.RESULTS(1)Among 84 MD patients complicated with hemorrhage,77 were male,and 7 were female with an average age of 31.31±10.75 years.The incidence was higher in men than in women of different ages;(2)Among the 84 MD patients,65(78.40%)had defecated dark red stools,and 50(58.80%)had no accompanying symptoms during bleeding,indicating that most MD bleeding appeared a dark red stool without accompanying symptoms;(3)The shock index of 71 patients(85.20%)was<1,suggesting that the blood loss of most MD patients was less than 20%–30%,and only a few patients had a blood loss of>30%;(4)The DBE-positive rate was 100%(54/54),99mTcpertechnetate-positive scanning rate was 78%(35/45)compared with capsule endoscopy(36%)and small intestine computed tomography(19%).These results suggest that DBE and 99mTc-pertechnetate scans had significant advantages in diagnosing MD and bleeding,especially DBE was a highly precise examination method in MD diagnosis;(5)A total of 54 MD patients with hemorrhage underwent DBE examination before surgery.DBE endoscopy revealed many mucosal manifestations including normal appearance,inflammatory changes,ulcerative changes,diverticulum inversion,and nodular hyperplasia,with ulcerative changes being the most common(53.70%).This suggests that diverticular mucosal ulcer was the main cause of MD and bleeding;

关 键 词：Meckel’s diverticulum with bleeding Double-balloon colonoscopy 99mTc-pertechnetate scanning Capsule endoscopy Ectopic gastric mucosa 

分 类 号：R735.31[医药卫生—肿瘤]