Mouawad Nicolas J, Hammond Stephen, Kaoutzanis Christodoulos
Department of General Surgery, Saint Joseph Mercy Health System, Ann Arbor, Michigan, USA.
BMJ Case Rep. 2013 Feb 20;2013:bcr2012008226. doi: 10.1136/bcr-2012-008226.
Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract, with an overall incidence of approximately 2.2%. It is generally noted incidentally during laparotomy for management of other abdominal pathology. Complications are infrequent, developing in 4% of individuals with this abnormality, and are usually seen in childhood. Herein, we discuss the case of a 52-year-old Caucasian man presenting with a 1-day history of worsening central and right-sided abdominal pain. Initial evaluation posed a broad differential however, following conservative measures and unremarkable plain films, the patient developed peritoneal signs necessitating operative intervention. During diagnostic laparoscopy, a Meckel's diverticulum was noted to be inflamed and perforated by an intact fish bone. The patient was treated successfully with a segmental resection and primary anastomosis, and had an uneventful postoperative recovery.
梅克尔憩室是胃肠道最常见的先天性异常，总体发病率约为2.2%。它通常在因其他腹部病变进行剖腹手术时偶然被发现。并发症并不常见，在患有这种异常的个体中发生率为4%，且通常在儿童期出现。在此，我们讨论一例52岁白种男性患者，其主诉有1天来中上腹和右腹疼痛加重的病史。初始评估提出了广泛的鉴别诊断，然而，在采取保守措施且平片检查无异常后，患者出现了腹膜刺激征，需要进行手术干预。在诊断性腹腔镜检查中，发现一个梅克尔憩室发炎并被一根完整的鱼骨穿孔。患者通过节段性切除和一期吻合术得到成功治疗，术后恢复顺利。
