Sami Akbulut, Yusuf Yagmur, Department of Surgery, Diyarbakir Education and Research Hospital, Diyarbakir 21400, Turkey.
World J Gastrointest Surg. 2014 Mar 27;6(3):47-50. doi: 10.4240/wjgs.v6.i3.47.
Meckel's diverticulum (MD) results from incomplete involution of the proximal portion of the vitelline (also known as the omphalomesenteric) duct during weeks 5-7 of foetal development. Although MD is the most commonly diagnosed congenital gastrointestinal anomaly, it is estimated to affect only 2% of the population worldwide. Most cases are asymptomatic, and diagnosis is often made following investigation of unexplained gastrointestinal bleeding, perforation, inflammation or obstruction that prompt clinic presentation. While MD range in size from 1-10 cm, cases of giant MD (≥ 5 cm) are relatively rare and associated with more severe forms of the complications, especially for obstruction. Herein, we report a case of giant MD with secondary small bowel obstruction in an adult male that was successfully managed by surgical resection and anastomosis created with endoscopic stapler device (80 mm, endo-GIA stapler). Patient was discharged on post-operative day 6 without any complications. Histopathologic examination indicated Meckel's diverticulitis without gastric or pancreatic metaplasia.
Meckel 憩室(MD)是由于胎儿发育第 5-7 周时卵黄囊(也称为卵黄肠管)近端部分不完全退化引起的。尽管 MD 是最常见的先天性胃肠道异常,但据估计,它仅影响全球 2%的人口。大多数病例无症状,通常在出现不明原因的胃肠道出血、穿孔、炎症或梗阻后进行检查,从而做出诊断。虽然 MD 的大小从 1-10 厘米不等,但巨大 MD(≥5 厘米)的病例相对较少,并且与更严重形式的并发症相关,特别是梗阻。在此,我们报告一例成年男性的巨大 MD 合并继发性小肠梗阻,成功通过手术切除和吻合(80 毫米,endo-GIA 吻合器)进行治疗。患者术后第 6 天无任何并发症出院。组织病理学检查提示 Meckel 憩室炎,无胃或胰腺化生。