Napoli F, di Marzo L, Morelli M M, Cavallaro A
I Istituto di Clinica Chirurgica, Università Roma, La Sapienza.
Ann Ital Chir. 1992 Jul-Aug;63(4):477-80: discussion 480-1.
The authors report a case of abdominal aortic aneurysm surgically treated. At surgical exploration an ileal diverticulum was discovered. A 15 cm ileum tract was hyperemic and oedematous. The abdominal aortic aneurysm was resected and an aorto aortic graft implanted. The retroperitoneal space was carefully closed and then the diverticulum resected and an end-to end intestinal anastomosis performed. An etiological review of this pathology was done identifying two possible causes: true and false diverticula. The true diverticulum is a congenital lesion involving the 3 layers of the intestinal wall. On the contrary the false diverticulum is acquired and generally develops on the mesenteric site due to a pulsion mechanism. The wall involves the mucosa and serosa layers only. Diagnosis is often done during abdominal exploration for other cause (as in our case) or for complicated diverticula. Preoperative radiologic diagnosis is rare and doesn't always require surgical treatment.
作者报告了一例接受手术治疗的腹主动脉瘤病例。在手术探查时发现了一个回肠憩室。一段15厘米长的回肠充血且水肿。切除腹主动脉瘤并植入主动脉移植物。仔细关闭腹膜后间隙,然后切除憩室并进行端端肠吻合术。对这种病理情况进行了病因学回顾,确定了两种可能的病因:真性和假性憩室。真性憩室是一种涉及肠壁三层的先天性病变。相反,假性憩室是后天获得性的,通常由于一种冲动机制在肠系膜部位形成。其壁仅涉及黏膜和浆膜层。诊断通常在因其他原因进行腹部探查时做出(如我们的病例),或针对复杂憩室。术前放射学诊断很少见,且并非总是需要手术治疗。