Maclean William, Szentpáli Karoly
General Surgery, Royal Hampshire County Hospital, Winchester, UK
Upper GI Surgery, Royal Hampshire County Hospital, Winchester, UK.
J Surg Case Rep. 2013 Dec 4;2013(12):rjt097. doi: 10.1093/jscr/rjt097.
We are reporting a successful laparoscopic resection of a perforated Meckel's Diverticulum (MD) causing localized peritonitis due to an impacted gallstone. MD is a small benign pouch on the wall of the small intestine that is present in ∼2% of the population. It results from a failure of complete obliteration of the omphalomesenteric duct. MD is mainly lined by ileal mucosa; however, other ectopic tissue types can be found including gastric, duodenal, colonic, pancreatic, Brunner's glands, hepatobiliary tissue and endometrial mucosa. Most reported complications include bleeding, infection and obstruction. With relevance to this report, we can find no more than two reports of a large gallstone impacting the neck of the MD and causing ileus, and we were unable to find any reports that mention perforation due to impaction at the neck of an MD.
我们报告了一例成功的腹腔镜下切除因胆结石嵌顿导致局限性腹膜炎的穿孔梅克尔憩室(MD)。MD是小肠壁上的一个小的良性袋状结构,约2%的人群中存在。它是由于卵黄管完全闭塞失败所致。MD主要由回肠黏膜内衬;然而,也可发现其他异位组织类型,包括胃、十二指肠、结肠、胰腺、布伦纳腺、肝胆组织和子宫内膜黏膜。大多数报道的并发症包括出血、感染和梗阻。与本报告相关的是,我们发现不超过两份关于大的胆结石嵌顿在MD颈部并导致肠梗阻的报告,并且我们未能找到任何提及因MD颈部嵌顿导致穿孔的报告。