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[成人梅克尔憩室炎的超声诊断]

[Ultrasound diagnosis of Meckel diverticulitis in adults].

作者信息

Wilhelm A, Langer C, Müller A, Becker H

机构信息

Klinik und Poliklinik für Allgemeinchirurgie, Georg-August-Universität Göttingen.

出版信息

Z Gastroenterol. 2001 Jan;39(1):73-5. doi: 10.1055/s-2001-10689.

Abstract

Meckel's diverticulitis is a rare disease. In addition to physical examination, abdominal ultrasound can help to pinpoint the diagnosis. By presenting a case report we would like to demonstrate the typical ultrasonographic findings in acute Meckel's diverticulitis and differentiate it from acute appendicitis. A 60-year-old patient was admitted to our hospital with the diagnosis of acute appendicitis. Abdominal ultrasound was performed and a blind ending, liquid-filled segment of small bowel in the right lower quadrant of the abdomen found. This segment was not compressible, no peristalsis was evident, nor was there any anatomical association with the cecum. Locally we found free fluid and hints of inflamed mesenteric fatty tissue. A perforated Meckel's diverticulum was diagnosed and confirmed intraoperatively. The major ultrasonographic difference between an inflamed Meckel's diverticulum and acute appendicitis is its anatomical location. In contrast to the appendix there is no association with the cecum. A diameter of up to 40 mm and a well-defined wall of small bowel with 3 definite layers visible by ultrasound may help to distinguish between a Meckel's diverticulum and the appendix.

摘要

梅克尔憩室炎是一种罕见疾病。除体格检查外,腹部超声有助于明确诊断。通过呈现一例病例报告,我们希望展示急性梅克尔憩室炎典型的超声表现,并将其与急性阑尾炎相鉴别。一名60岁患者因急性阑尾炎诊断入院。进行了腹部超声检查,发现腹部右下腹有一段盲端、充满液体的小肠。该段不可压缩,未见蠕动,与盲肠也无解剖学关联。局部可见游离液体及肠系膜脂肪组织炎症迹象。术中诊断并证实为穿孔性梅克尔憩室。发炎的梅克尔憩室与急性阑尾炎在超声上的主要区别在于其解剖位置。与阑尾不同,它与盲肠无关联。直径达40毫米且超声可见小肠壁界限清晰并有三层明确结构,这可能有助于区分梅克尔憩室和阑尾。

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