Oyachi Noboru, Takano Kunio, Hasuda Norio, Arai Hiroshi, Koshizuka Kozo, Matsumoto Masahiko
Division of Pediatric Surgery, Second Department of Surgery, Faculty of Medicine, Yamanashi University, 1110 Shimokato, Chuo, Yamanashi 409-3898, Japan.
Surg Today. 2007;37(10):881-3. doi: 10.1007/s00595-007-3519-3. Epub 2007 Sep 26.
We report a case of perforated Meckel's diverticulum with aseptic peritonitis in a 17-day-old neonate. The baby had been brought to the hospital with fever and abdominal distention. Abdominal computed tomography showed a 5-cm abscess in the lower abdomen, and emergency laparotomy was performed for suspected perforated appendicitis. However, we found a perforated Meckel's diverticulum. No bacteria were detected in the purulent ascites from the peritoneal cavity. We speculate that the narrow lumen between the small intestine and the diverticulum, accompanied by poor self-emptying had caused acute inflammation resulting in perforation of Meckel's diverticulum. The anatomic limitations in "walling off" the perforated Meckel's diverticulum by the surrounding loops of small intestine prevented the bowel contents from spreading within the peritoneal cavity.
我们报告一例17日龄新生儿的梅克尔憩室穿孔伴无菌性腹膜炎病例。该婴儿因发热和腹胀被送至医院。腹部计算机断层扫描显示下腹部有一个5厘米的脓肿,因怀疑阑尾穿孔而进行了急诊剖腹手术。然而,我们发现的是梅克尔憩室穿孔。腹腔脓性腹水中未检测到细菌。我们推测,小肠与憩室之间狭窄的管腔,加上自身排空不良,导致了急性炎症,进而引起梅克尔憩室穿孔。小肠周围肠袢对穿孔的梅克尔憩室进行“包裹”的解剖学限制,阻止了肠内容物在腹腔内扩散。