Lu Chung-Ching, Huang Fu-Chen, Lee Shin-Yi, Huang Hsiu-Yu
Department of Pediatrics, Chang Gung Memorial Hospital, No. 123, Ta-Pei Road, Niaosung Hsiang, Kaohsiung Hsien, Taiwan.
Acta Paediatr Taiwan. 2003 Jan-Feb;44(1):41-3.
Meckel's diverticulum is a common cause of low gastrointestinal bleeding in childhood. Conventional diagnostic methods including plain abdominal radiographs, abdominal ultrasound, technectium 99m pertechnetate scintigraphy, angiography, and exploratory laparotomy have several limitations. Here, we report that a case of Meckel's diverticulum in a 1-year-7-month-old boy presenting with intermittent episodes of painless low gastrointestinal bleeding for about one year. Despite the traditional studies, including plain abdominal films, abdominal ultrasound, rectosigmoidoscopy and repeated Tc-99m Meckel's scan, all showed negative finding, it was successfully diagnosed along with excision of Meckel's diverticulum by laparoscopy. The patient made a rapid recovery and discharged at 48 hours after the procedure. We emphasize that laparoscopy should be an alternative diagnostic and therapeutic modality of choice in patients suspected of Meckel's diverticulum, especially in pediatric patients who had negative results of all other work-ups.
梅克尔憩室是儿童下消化道出血的常见原因。传统的诊断方法包括腹部平片、腹部超声、锝99m高锝酸盐闪烁扫描、血管造影和剖腹探查术,都有一些局限性。在此,我们报告一例1岁7个月大的男孩患有梅克尔憩室,表现为间歇性无痛性下消化道出血约一年。尽管进行了包括腹部平片、腹部超声、直肠乙状结肠镜检查和重复的锝99m梅克尔扫描在内的传统检查,结果均为阴性,但通过腹腔镜检查成功诊断出梅克尔憩室并将其切除。患者恢复迅速,术后48小时出院。我们强调,对于疑似梅克尔憩室的患者,尤其是所有其他检查结果均为阴性的儿科患者,腹腔镜检查应作为一种可供选择的诊断和治疗方式。