Abstract:Objective: To investigate the diagnostic value of balloon-assisted small enteroscopy and other examination methods for Meckel’s diverticulum of the small intestine. Methods: A retrospective analysis was conducted on 87 patients who were diagnosed with Meckel’s diverticulum at the First Affiliated Hospital of Nanjing Medical University between January 2010 and December 2023. Data regarding demographics, clinical presentations, diagnostic methods, treatments, and pathological findings were collected. We summarized the clinical characteristics of patients with Meckel’s diverticulum and compared the diagnostic efficacy of balloon-assisted small enteroscopy with other diagnostic methods for detecting Meckel’s diverticulum. Results: A total of 87 patients with Meckel’s diverticulum were included, with 55 patients presenting complications such as gastrointestinal bleeding, intestinal obstruction, diverticulitis, and intestinal perforation. Patients with Meckel’s diverticulum and complications exhibited a younger median age (29(34): 49.5(34), P=0.003), larger diverticulum diameter (5.2±2.6: 3.3±1.4, P=0.001), wider openings (2.4±1.1: 1.6±0.7, P=0.002), and a higher likelihood of undergoing surgery (89.1%(49/55): 56.3%(18/32), P=0.000) compared to those without complications. The diagnostic sensitivity of different examination methods for Meckel’s diverticulum was as follows: abdominal CT 8.2%(4/49); CT enterography 9.4%(3/32); digital subtraction angiography 0.0%(0/9); nuclide imaging (ectopic gastric mucosal imaging) 58.3%(7/12); capsule endoscopy 30.0%(3/10); and balloon-assisted small enteroscopy 94.4% (34/36). Conclusion: Meckel’s diverticulum in young patients, characterized by a long diverticulum diameter and wide openings, is more prone to complications such as diverticulitis, perforation, bleeding, and obstruction. Balloon-assisted small enteroscopy emerges as the most reliable preoperative diagnostic modality for Meckel’s diverticulum and should be the preferred examination for patients with suspected Meckel’s diverticulum.