Virtual Enteroscopic Images of Meckel's Diverticulum

Abstract

V enteroscopy (VE) is a newly developed method to explore the entire small intestine with a modified protocol f virtual colonoscopy by inflating the small intestine with air hrough a jejunum-intubated tube and depicting the wall of the mall intestine. A 66-year-old man presented to our hospital with progressive nemia and a positive fecal occult blood test. He had undergone emodialysis for 15 years for renal failure caused by chronic lomerulonephritis. Erythropoietin and nonsteroidal anti-inammatory drugs (NSAIDs) had been given regularly for renal nemia and chronic thoracic pain. Esophagogastroduodenosopy and colonoscopy were performed, but the source of bleedng could not be identified. Video capsule endoscopy (VCE) was erformed, and multiple small erosions in the small bowel were ound. VE was performed, revealing the total length of the small owel was 595 cm (Figure A, B). At 103 cm from the ileocecal alve (Figure B, white arrow), an 8-cm–long diverticulum was depicted (Figure C, luminal view; Figure D, 3-dimensional overview; Figure E, wall view; black arrow, lumen of the intestine; white arrow, opening of the diverticulum; Supplementary Video 1), which could not be identified in a second look of the results of VCE. Meckel scan results were negative. Erosions found by VCE were not depicted by VE. Considering the location, size, and shape, a diagnosis of Meckel’s diverticulum was made. The dose of NSAIDs was reduced, and the patient has been observed for 4 months, with gradual recovery from anemia.