Table 2. The different modalities’ diagnostic accuracies and yields in the diagnosis of Meckel’s diverticulum in patients with obscure gastrointestinal bleeding.
n | Certain or presumptive MD | Other significant findings* | Non-diagnostic | Diagnostic accuracy (95% CI) | P | Diagnostic yield (95% CI) | p | |
---|---|---|---|---|---|---|---|---|
Meckel’s scan | 14 | 3 | 0 | 11 | 21.4 (5.7–51.2) | referent | 21.4 (5.7–51.2) | referent |
Capsule endoscopy | 14 | 5 | 6¶ | 3 | 35.7 (14.0–64.4) | 0.675 | 78.6 (48.8–94.3) | 0.008 |
Balloon-assisted enteroscopy | 20 | 17 | 2∫ | 1 | 85.0 (61.1–96.0) | 0.001 | 95.0 (73.1–99.7) | <0.001 |
Mesenteric angiography | 2 | 0 | 1§ | 1 | 0.0 (0.0–80.2) | 0.808 | 50.0 (2.7–97.3) | 0.999 |
CT of the abdomen and pelvis | 22 | 7 | 6† | 9 | 31.8 (14.7–54.9) | 0.766 | 59.1 (36.7–78.5) | 0.061 |
Small bowel follow-through | 8 | 5 | 1‡ | 2 | 62.5 (25.9–90.0) | 0.142 | 75.0 (35.6–95.5) | 0.045 |
RBC scan | 4 | 0 | 0 | 4 | 0.0 (0.0–60.4) | 0.801 | 0.0 (0.0–60.4) | 0.801 |
Abbreviation: MD, Meckel’s diverticulum; Meckel’s scan, Technetium-99m pertechnetate scintigraphy; CT, computed tomography; RBC scan, Technetium-99m red blood cell scintigraphy.
* provided grounds to pursue further evaluation, but insufficient to diagnose to MD
†ileal wall thickening of unknown origin (n = 3), enteritis of unknown cause (n = 1), focal stricture (n = 1), obstruction (n = 1)
‡ulcers with pseudosacculation in the proximal ileum (n = 1)
§active bleeding from ileal branches of SMA (n = 1)
¶blood in lumen (n = 3), ulcerative lesions on the ileum (n = 2), Dieulafoy lesion (n = 1)
∫blood in lumen (n = 1), several ulcers in terminal ileum (n = 1)