Chan Kim W
Department of General Surgery, Royal Blackburn Hospital, Blackburn BB2 3EZ, UK.
J Med Case Rep. 2009 Feb 3;3:48. doi: 10.1186/1752-1947-3-48.
Meckel's diverticulum represents a true diverticulum of the ileum containing all three layers of the bowel wall and is found on the wall of the distal ileum, usually about 2 feet from the ileocaecal valve. Although Meckel's diverticulum is a common congenital abnormality of the gastrointestinal tract, it is often difficult to diagnose. Patients with perforation of Meckel's diverticulum may present with right iliac fossa pain, which mimics acute appendicitis.
A 17-year-old man presented with a 3-day history of lower abdominal pain. On examination, the patient had tenderness in his right iliac fossa. A provisional diagnosis of acute appendicitis was made. The patient was taken to theatre for laparoscopy with the option of appendicectomy. The appendix was found to be normal. An inflamed and perforated Meckel's diverticulum was found to be the cause of the abdominal pain. Meckel's diverticulectomy was performed. The patient made an uneventful recovery and was discharged with further follow-up in the outpatient clinic.
Complications of Meckel's diverticulum can be fatal and early recognition leads to appropriate management. This case report highlights the importance of considering Meckel's diverticulum as a differential diagnosis of acute abdomen in a young patient.
梅克尔憩室是回肠的真性憩室,包含肠壁的所有三层结构,位于回肠末端肠壁上,通常距回盲瓣约2英尺。虽然梅克尔憩室是胃肠道常见的先天性异常,但通常难以诊断。梅克尔憩室穿孔的患者可能表现为右下腹疼痛,类似急性阑尾炎。
一名17岁男性,有3天的下腹痛病史。检查时,患者右下腹有压痛。初步诊断为急性阑尾炎。患者被送往手术室进行腹腔镜检查,并可选择阑尾切除术。阑尾检查正常。发现一个发炎并穿孔的梅克尔憩室是腹痛的原因。遂进行了梅克尔憩室切除术。患者恢复顺利,出院后在门诊进一步随访。
梅克尔憩室的并发症可能是致命的,早期识别有助于进行适当的治疗。本病例报告强调了在年轻患者中将梅克尔憩室作为急腹症鉴别诊断的重要性。