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DOI: 10.1055/a-2612-3215
Value of preoperative enteroscopic carbon nanoparticle labeling in guiding laparoscopic resection of Meckel’s diverticulum
Meckel’s diverticulum is a congenital digestive tract malformation, with a prevalence of 0.3% to 2.9% in the general population [1] [2] [3]. Only 15% of patients with Meckel’s diverticulum are symptomatic and preoperative diagnosis with gastrointestinal endoscopy is limited [3]. Enteroscopy provides precise anatomical guidance for minimally invasive surgery. Herein, we report two rare cases of patients presenting with hematochezia. In both cases, enteroscopy revealed the Meckel’s diverticulum, and carbon nanoparticle labeling was subsequently performed. The lesions were resected via laparoscopic surgery guided by carbon nanoparticle labeling ([Video 1]).
Value of preoperative enteroscopic carbon nanoparticle labeling in guiding laparoscopic resection of Meckel’s diverticulum.Video 1Patient 1: A 20-year-old man presented with a 4-day history of hematochezia. Previous gastrointestinal endoscopy failed to identify the bleeding source. Subsequent enteroscopy revealed a diverticulum with a narrow opening, located 200 cm proximal to the ileocecal valve. Submucosal injection of carbon nanoparticles was performed around the lesion for marking. Then, laparoscopic exploration guided by carbon nanoparticle labeling confirmed the diverticulum, measuring 4 × 1.2 cm, and segmental small-bowel resection was performed. Histopathology confirmed Meckel’s diverticulum with normal ileal wall ([Fig. 1]).


Patient 2: A 17-year-old man was admitted with recurrent hematochezia for over 1 year and recurrence for 3 days. Previous colonoscopy failed to identify the bleeding source. Subsequent enteroscopy found a giant diverticulum with the blind end of the diverticulum showing irregular mucosal protrusions ([Fig. 2]). Narrow-band imaging showed heterotopic gastric mucosa characteristics ([Fig. 3]). A tortuous submucosal artery with visible pulsation was observed adjacent to the lesion. The lesion was marked using carbon nanoparticles and a preliminary diagnosis of Meckel’s diverticulum was established. Then, the patient was transferred for laparoscopic surgical intervention. Laparoscopic exploration revealed the giant diverticulum in the distal ileum, approximately 100 cm proximal to the ileocecal valve ([Fig. 4]). Histopathology confirmed Meckel’s diverticulum containing heterotopic gastric mucosa ([Fig. 5]).








Enteroscopy with carbon nanoparticle labeling provides precise anatomical guidance for minimally invasive surgery.
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Conflict of Interest
The authors declare that they have no conflict of interest.
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References
- 1 Bejiga G, Ahmed Z. Gangrenous Meckel’s diverticulum with small bowel obstruction mimicking complicated appendicitis: ‘case report’. Int J Surg Case Rep 2022; 97: 107419
- 2 Hu S, Du H, Wen J. et al. Diagnosis of inverted Meckel’s diverticulum by double-balloon enteroscopy: a case report. AME Case Rep 2024; 8: 33
- 3 Gomes GF, Bonin EA, Noda RW. et al. Balloon-assisted enteroscopy for suspected Meckel’s diverticulum and indefinite diagnostic imaging workup. World J Gastrointest Endosc 2016; 8: 679-683
Correspondence
Publication History
Article published online:
26 June 2025
© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).
Georg Thieme Verlag KG
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References
- 1 Bejiga G, Ahmed Z. Gangrenous Meckel’s diverticulum with small bowel obstruction mimicking complicated appendicitis: ‘case report’. Int J Surg Case Rep 2022; 97: 107419
- 2 Hu S, Du H, Wen J. et al. Diagnosis of inverted Meckel’s diverticulum by double-balloon enteroscopy: a case report. AME Case Rep 2024; 8: 33
- 3 Gomes GF, Bonin EA, Noda RW. et al. Balloon-assisted enteroscopy for suspected Meckel’s diverticulum and indefinite diagnostic imaging workup. World J Gastrointest Endosc 2016; 8: 679-683









