1Scuola di Specializzazione in Pediatria, Università di Trieste
2Clinica Pediatrica, IRCCS Pediatrico “Burlo Garofolo”, Trieste
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Key words: Meckel diverticulum, Video capsule endoscopy, Scintigraphy, Laparoscopy
The possibility of using video capsule endoscopy for diagnosing is known. Nevertheless only case reports or small case series have been published to date. Data of patients referred to our Pediatric department who were diagnosed with Meckel diverticulum from January 2009 to February 2011 were analysed. 8 cases, 5 males and 3 females were identified. Intestinal bleeding was the most common clinical manifestation (6 patients) while abdominal pain and iron deficiency anaemia were the presenting sign for two patients. Seven of these patients underwent video capsule endoscopy and in 6 a 99Tc scintigraphy was also performed. In 5 cases video capsule endoscopy images were suggestive of Meckel diverticulum. Scintigraphy was positive in 3 out of 6 patients. Both tests were positive in 2 patients and in 1 patient both were negative and diagnosis was made by a laparoscopic exploration. Video capsule endoscopy allowed the diagnosis in 2 of 3 patients who had a negative scintigraphy to be made. In conclusion, even though the association of video capsule endoscopy and scintigraphy allowed correct diagnosis in most patients, their negativity does not completely exclude the diagnosis of Meckel diverticulum. Therefore, in presence of a strongly suggestive presentation, laparoscopic exploration remains unavoidable.
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