title: Endoscopic observation of Meckel's diverticulum by double balloon endoscopy: report of five cases.
abstract: OBJECTIVE
  Most cases of Meckel's diverticula are asymptomatic, however, some cases presented with gastrointestinal (GI) bleeding. It is often difficult to determine whether Meckel's diverticulum is a source of obscure GI bleeding. Double balloon endoscopy allows endoscopic access to the entire small intestine. The aim of this study was to compare endoscopic findings of three hemorrhagic and two non-hemorrhagic Meckel's diverticula in patients with obscure GI bleeding using this novel technique.
  
  
  METHODS
  Between September 2000 and April 2005, 354 enteroscopies, including 162 anterograde and 192 retrograde procedures, were performed on 217 patients at the Jichi Medical University Hospital, Japan, using the double balloon endoscopy system. Five consecutive patients where Meckel's diverticulum was endoscopically observed were selected and analyzed.
  
  
  RESULTS
  Double balloon endoscopy enabled direct observation of Meckel's diverticula in all five patients. Surgical procedures were indicated for three patients where double balloon endoscopy discovered ulcers. By contrast, double balloon endoscopy detected other sources of bleeding in the remaining two patients where no ulcers were found in the Meckel's diverticula.
  
  
  CONCLUSIONS
  Endoscopic observation of the ulcers in Meckel's diverticula was important evidence of bleeding in patients with obscure GI bleeding. Other sources of bleeding should be considered when no ulcers are found in the Meckel's diverticula.
authors.affiliation: Department of Internal Medicine, Division of Gastroenterology, Jichi Medical University, Tochigi, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Shinozaki
authors.forename: Hironori
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Hirohide
authors.initials: H
authors.lastname: Ohnishi
authors.forename: Hiroto
authors.initials: H
authors.lastname: Kita
authors.forename: Tomonori
authors.initials: T
authors.lastname: Yano
authors.forename: Michiko
authors.initials: M
authors.lastname: Iwamoto
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Miyata
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Hayashi
authors.forename: Keijiro
authors.initials: K
authors.lastname: Sunada
authors.forename: Kenichi
authors.initials: K
authors.lastname: Ido
authors.forename: Norio
authors.initials: N
authors.lastname: Takayashiki
authors.forename: Kentaro
authors.initials: K
authors.lastname: Sugano
mesh_terms: D000328:Adult; D000368:Aged; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D008297:Male; D008467:Meckel Diverticulum / Q000150:complications / Q000175:diagnosis*; D008875:Middle Aged; D055815:Young Adult