title: Capsule endoscopy is useful diagnostic tool for diagnosing Meckel's diverticulum.
abstract: OBJECTIVE
  Meckel's diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract. Although a majority of patients remain asymptomatic, complications may occur in a subset of patients. MD is a rare cause of gastrointestinal bleeding (GIB) in adults. We aimed to clarify the possible role of capsule endoscopy (CE) in the identification of Meckel's diverticulum.
  
  
  METHODS
  From October 2004 to December 2010, 157 CEs were performed (83 male individuals, mean age 51±20 years; range 3-83 years) for obscure GIB. Before CE, all patients underwent nonconclusive upper and lower endoscopy at least two times and barium follow-through.
  
  
  RESULTS
  CE identified the source of bleeding in 70/157 patients (44.6%). MD was diagnosed in 13/70 (18.6%) patients (11 male individuals, mean age 35±20 years, range, 3-69 years) after CE. Nine patients presented with obscure overt and four with obscure occult bleeding. The mean duration of obscure GIB history was 13 months (range 1-72 months). The mean hemoglobin concentration at the time of the procedure was 115±12 g/l. The findings of MD on CE were double lumen sign (13/13), visible blood (7/13), and diaphragm sign (6/13). All patients were operated upon, and MD histologically verified in 11. In two patients CE was false-positive and in two patients, false-negative. Capsule endoscopy had a positive predictive value of 84.6% for the diagnosis of MD.
  
  
  CONCLUSIONS
  MD should be considered in the differential diagnosis of obscure GIB in adults. CE is an effective and promising modality for diagnosing MD in patients with obscure GIB.
authors: aSchool of Medicine, University of Belgrade bCenter of Emergency Surgery cClinic for Gastroenterology and Hepatology, Clinical Center of Serbia, Belgrade, Serbia.
authors: Slobodan N
authors: SN
authors: Krstic
authors: Jelena B
authors: JB
authors: Martinov
authors: Aleksandra D
authors: AD
authors: Sokic-Milutinovic
authors: Tomica N
authors: TN
authors: Milosavljevic
authors: Miodrag N
authors: MN
authors: Krstic
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D053704:Capsule Endoscopy; D002648:Child; D002675:Child, Preschool; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D008297:Male; D008467:Meckel Diverticulum / Q000150:complications / Q000175:diagnosis*; D008875:Middle Aged; D011237:Predictive Value of Tests; D055815:Young Adult
chemical_list: D006454:Hemoglobins