Capsule retention in a giant Meckel's diverticulum containing multiple enteroliths.

with diffuse abdominal pain, melena, and iron-deficiency anemia. Gastroscopy and colonoscopywere unremarkable.Wireless capsule endoscopy (WCE) (PillCam SB2; Given Imaging, Yoqneam, Israel) was then carried out. The video sequence showed the capsule passing through a narrow orifice of the distal ileum into a cavity containing multiple enteroliths swirling in a greenish fluid with debris (●" Figs. 1 and 2). Small ulcerswere also demonstrated near the orifice in the bowel lumen. The capsule remained within the cavity until the battery was exhausted. Consequently, computed tomography (CT) demonstrated adilatedpartof thebowel at the right abdomen, filledwith enteral contrast and containing a hyperdense foreign body – corresponding to the capsule – and multiple ovoid structures, each with a thick rim of intermediate density and low-density center (●" Fig. 3). The patient was operated on, and a giant enteral diverticulum (●" Fig. 4) containing the capsule and four enteroliths was found (●" Fig. 5). Histological examination proved this to be a Meckel’s diverticulum with few small ulcers, without the presence of ectopic gastric mucosa. Obscure gastrointestinal bleeding is the most common indication for WCE, yielding high detection and low retention rates [1]. Crohn’s disease, neoplasia, abdominal radiation injury, prolonged nonsteroidal anti-inflammatory drug use, and previous major abdominal surgery or small-bowel resection are the most common reasons for capsule retention [1]. There are few reported cases of capsule retention in a small-bowel diverticulum, either a simple diverticulum or Meckel’s diverticulum [2–4]. Meckel’s diverticula that do not have gastric mucosa – like in our case – create a more alkaline environment, promoting precipitation of calcium and other minerals essential for enterolith formation [5]. It has been reported that only 10% of Meckel’s diverticula contain enteroliths [5]. To our knowledge, this is the first report of WCE providing images of aMeckel’s diverticulum containing enteroliths. Capsule retention in a giant Meckel’s diverticulum containing multiple enteroliths