Demystifying Meckel's diverticulum - a guide for the gastroenterologist.

IF 2.6 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Current Opinion in Gastroenterology Pub Date : 2025-05-01 Epub Date: 2025-03-06 DOI:10.1097/MOG.0000000000001085

Kimberley Butler, Thomas Peachey, Reena Sidhu, Foong Way David Tai

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引用次数: 0

Abstract

Purpose of review: Meckel's diverticulum (MD) is a common congenital ileal diverticulum. Whilst mostly asymptomatic, 4-9% develop complications, such as small bowel obstruction, diverticulitis or bleeding. In 1933, Charles Mayo wrote that MD is 'frequently suspected, often looked for and seldom found', and it continues to pose a diagnostic challenge today. With advancements in small bowel imaging and endoscopy, this review outlines the gastroenterologist's approach to MD.

Recent findings: There are a number of strategies for diagnosing MD. Meckel's scan has a sensitivity of 80-92% in children but 62-88% in adults. The diagnostic yield of small bowel capsule endoscopy (SBCE) is only up to 50%. Device-assisted enteroscopy (DAE) has a sensitivity of 84-100% for MD but is invasive. The definitive treatment for symptomatic MD is surgical resection, but the management of asymptomatic cases are controversial. A recent systematic review favoured resection of incidental MD.

Summary: A high index of suspicion and a multimodality combination of SBCE, Meckel's scan, CT and DAE is often required to diagnose MD. Complicated MD is treated by surgical resection. Management of incidental MD remains debated, although current evidence appears to favour resection.

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揭开梅克尔憩室的神秘面纱——胃肠病学家指南。

综述目的：Meckel憩室（MD）是一种常见的先天性回肠憩室。虽然大多数无症状，但4-9%会出现并发症，如小肠梗阻、憩室炎或出血。1933年，查尔斯·梅奥（Charles Mayo）写道，MD“经常被怀疑，经常被寻找，但很少被发现”，今天它仍然对诊断构成挑战。随着小肠成像和内窥镜技术的进步，本综述概述了胃肠病学家对MD的诊断方法。最近的发现：有许多诊断MD的策略。Meckel扫描在儿童中的灵敏度为80-92%，而在成人中为62-88%。小肠胶囊内窥镜（SBCE）的诊断率仅为50%。器械辅助肠镜检查（DAE）对MD的敏感性为84-100%，但具有侵入性。对症状性MD的最终治疗是手术切除，但对无症状病例的处理存在争议。摘要：诊断MD通常需要高怀疑指数和SBCE、Meckel扫描、CT和DAE的多模态联合检查。复杂MD的治疗方法是手术切除。偶发性MD的处理仍有争议，尽管目前的证据似乎倾向于切除。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Opinion in Gastroenterology 医学-胃肠肝病学

CiteScore

5.30

自引率

0.00%

发文量

137

审稿时长

6-12 weeks

期刊介绍： Published bimonthly and offering a unique and wide ranging perspective on the key developments in the field, each issue of Current Opinion in Gastroenterology features hand-picked review articles from our team of expert editors. With twelve disciplines published across the year – including gastrointestinal infections, nutrition and inflammatory bowel disease – every issue also contains annotated references detailing the merits of the most important papers.