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在治疗蛔虫性肠梗阻的急诊手术中遇到 Meckel 憩室。

Encountering Meckel's diverticulum in emergency surgery for ascaridial intestinal obstruction.

机构信息

Department of Surgery, SMHS Hospital, Srinagar, Kashmir, India.

出版信息

World J Emerg Surg. 2010 Jun 9;5:15. doi: 10.1186/1749-7922-5-15.

Abstract

BACKGROUND

Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract. In children with intestinal ascariasis, the diverticulum remains asymptomatic or rarely the Ascaris lumbricoides may lead to its complications in the presence of massive intestinal roundworm load. Given that preoperative diagnosis is seldom carried out, when Meckel's diverticulum is found at laparotomy for obstructive intestinal complications of roundworm, the diverticulum should be removed as complications may occur at any time. The aim of this study was to describe the findings of concomitant presence of Meckel's diverticulum who had surgical intervention in symptomatic intestinal ascariasis in children.

METHODS

A retrospective case review study of 14 children who had surgical intervention for symptomatic intestinal ascariasis having the presence of concomitant Meckel's diverticulum was done. The study was done at SMHS Hospital Srinagar, Kashmir.

RESULTS

A total of the 14 children who had ascaridial intestinal obstruction with concomitant presence of Meckel's diverticulum were studied. Age of children ranged from 4-12 years, male:female ratio was 1.8:1. Nine patients had asymptomatic Meckel's diverticulum, whereas 5 patients with symptomatic signs were found in the course of emergency surgery for ascaridial intestinal obstruction.

CONCLUSION

Meckel's diverticulum in intestinal ascariasis may pursue silent course or may be accompanied with complications of the diverticulitis, perforation or the gangrene. Incidental finding of the Meckel's diverticulum in the intestinal ascariasis should have removal.

摘要

背景

梅克尔憩室是胃肠道最常见的先天性异常。在患有肠蛔虫病的儿童中,憩室通常无症状,或在大量肠道蛔虫负荷的情况下,蛔虫可能导致其并发症。由于术前诊断很少进行,因此在剖腹探查因蛔虫引起的梗阻性肠并发症时发现梅克尔憩室,应将其切除,因为并发症可能随时发生。本研究旨在描述在有症状的肠蛔虫病儿童中同时存在梅克尔憩室并进行手术干预的发现。

方法

对在 SMHS 医院 Srinagar,Kashmir 因有症状的肠蛔虫病而同时存在梅克尔憩室而行手术干预的 14 名儿童进行回顾性病例研究。

结果

共研究了 14 名患有蛔虫性肠梗阻且同时存在梅克尔憩室的儿童。儿童的年龄范围为 4-12 岁,男女比例为 1.8:1。9 名患者无症状的梅克尔憩室,而在因蛔虫性肠梗阻进行急诊手术时发现 5 名患者有症状体征。

结论

肠蛔虫病中的梅克尔憩室可能表现为隐匿性病程,也可能伴有憩室炎、穿孔或坏疽等并发症。在肠蛔虫病中偶然发现的梅克尔憩室应予以切除。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/be8b/2908070/bebf8c5bbcc1/1749-7922-5-15-1.jpg

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