Riddiough Georgina E, Bhatti Imran, Ratliff David A
Department of Vascular Surgery, Northampton General Hospital, Cliftonville, Northampton NN1 5BD, United Kingdom.
Int J Surg Case Rep. 2012;3(1):25-6. doi: 10.1016/j.ijscr.2011.10.008. Epub 2011 Oct 25.
Meckel's diverticulum is a rare congenital abnormality arising due to the persistence of the vitelline duct in 1-3% of the population. Clinical presentation is varied and includes rectal bleeding, intestinal obstruction, diverticulitis and ulceration; therefore diagnosis can be difficult.
We report a case of acute appendicitis complicated by persistent post operative small bowel obstruction. Further surgical examination of the bowel revealed an non-inflamed, inverted Meckel's diverticulum causing intussusception.
Intestinal obstruction in patients with Meckel's diverticulum may be caused by volvulus, intussusception or incarceration of the diverticulum into a hernia. Obstruction secondary to intussusception is relatively uncommon and frequently leads to a confusing and complicated clinical picture.
Consideration of Meckel's diverticulum although a rare diagnosis is imperative and this case raises the question "should surgeons routinely examine the bowel for Meckel's diverticulum at laparoscopy?"
梅克尔憩室是一种罕见的先天性异常，因卵黄管持续存在而引起，在1%至3%的人群中出现。临床表现多样，包括直肠出血、肠梗阻、憩室炎和溃疡；因此诊断可能困难。
我们报告一例急性阑尾炎并发术后持续性小肠梗阻的病例。对肠道进行进一步手术检查发现一个未发炎、内翻的梅克尔憩室导致肠套叠。
梅克尔憩室患者的肠梗阻可能由憩室扭转、肠套叠或憩室嵌入疝引起。肠套叠继发的梗阻相对少见，常导致复杂且令人困惑的临床情况。
尽管梅克尔憩室的诊断罕见，但必须考虑到，该病例提出了一个问题：“外科医生在腹腔镜检查时是否应常规检查肠道有无梅克尔憩室？”
