Bertozzi Mirko, Melissa Berardino, Radicioni Maurizio, Magrini Elisa, Appignani Antonino
From the *S.C. di Clinica Chirurgica Pediatrica, Università degli Studi di Perugia, Ospedale S. Maria della Misericordia Loc. S. Andrea delle Fratte; and †S.S. di Terapia Intensiva Neonatale Ospedale S. Maria della Misericordia Loc. S. Andrea delle Fratte, Perugia, Italy.
Pediatr Emerg Care. 2013 Sep;29(9):1002-5. doi: 10.1097/PEC.0b013e3182a315e5.
This study aimed to review the literature about symptomatic Meckel's diverticulum (MD) in the neonatal period with 2 additional uncommon cases.
The authors describe 2 interesting neonatal cases of symptomatic MD and analyze the literature on this topic, with particular reference to the prevalence of sex, age at presentation, most common signs and symptoms, treatment, histology, associated anomalies, and outcome.
The first patient was a term newborn with bowel obstruction by a pseudocystic MD. The second patient was a preterm infant with double perforation of the MD and ileum. Literature search for published case reports and case series on this topic reveals only 18 cases of neonatal symptomatic MD. Males are more frequently involved than females, and even preterm infants may be affected. Bowel obstruction (58.3%) and pneumoperitoneum (33.3%) are the most frequent clinical manifestation. Acute inflammation of the MD is the prominent histopathological finding (75%), although it does not seem to be related with the presence of heterotopic tissue within the MD. Surgical treatment is essential. The association of neonatal symptomatic MD with other anomalies is exceptional but is otherwise life threatening despite surgery.
Bowel obstruction and pneumoperitoneum are the most frequent clinical manifestations of symptomatic MD in the newborn. Surgery is required for a definitive diagnosis and successful outcome.
本研究旨在回顾关于新生儿期有症状的梅克尔憩室（MD）的文献，并增加2例罕见病例。
作者描述了2例有趣的有症状MD的新生儿病例，并分析了关于该主题的文献，特别提及性别患病率、就诊年龄、最常见的体征和症状、治疗、组织学、相关异常及预后。
首例患者为足月儿，因假性囊肿型MD导致肠梗阻。第二例患者为早产儿，MD和回肠出现双重穿孔。检索关于该主题已发表的病例报告和病例系列发现，仅有18例新生儿有症状MD。男性比女性更常受累，甚至早产儿也可能受到影响。肠梗阻（58.3%）和气腹（33.3%）是最常见的临床表现。MD的急性炎症是突出的组织病理学发现（75%），尽管这似乎与MD内异位组织的存在无关。手术治疗至关重要。新生儿有症状MD与其他异常的关联罕见，但即便手术也可能危及生命。
肠梗阻和气腹是新生儿有症状MD最常见的临床表现。明确诊断和取得成功预后需要手术治疗。
