Riccardo Guanà, Valeria Bucci, Giulia Carbonaro, Alessia Cerrina, Luisa Ferrero, Elisabetta Teruzzi, Alessandro Mussa, Isabella Morra, Jürgen Schleef
Department of Pediatrics, Turin University, Turin, Italy.
Afr J Paediatr Surg. 2014 Oct-Dec;11(4):354-8. doi: 10.4103/0189-6725.143172.
Meckel's diverticulum, the most common congenital abnormality of the small intestine, may be associated to heterotopic pancreas, often diagnosed incidentally on histopathological examination. Intussusception affects infants between the ages of 5 and 9 months, but it may also occur in older children, teenagers and adults, and in some cases can be derived by a Meckel's diverticulum resulting in acute abdomen. We analyse the management and the recent literature on similar cases, describing diagnostic options. In May 2013, a 7-year-old girl admitted to our hospital with recurrent gastrointestinal bleeding, was discovered to have an ileoileal intussusception with a leading Meckel's diverticulum with heterotopic pancreatic tissue. This association is rare evidence in children and its proper management can be controversial, in particular from a diagnostic point of view. In such cases, preoperative radiological diagnosis can be only suspected in the presence of suggestive signs, more often depicted by ultrasound or computed tomography scan. During laparotomy an accurate exploration of all ileum is recommended, for the possibility to find others heterotopic segments.
梅克尔憩室是小肠最常见的先天性异常，可能与异位胰腺有关，常在组织病理学检查时偶然发现。肠套叠多见于5至9个月大的婴儿，但也可发生于大龄儿童、青少年及成人，某些情况下可由梅克尔憩室引起急腹症。我们分析了类似病例的处理方法及近期文献，并描述了诊断方法。2013年5月，一名7岁女童因反复胃肠道出血入院，被发现患有回肠套叠，套入部为带有异位胰腺组织的梅克尔憩室。这种关联在儿童中罕见，其恰当处理存在争议，尤其是在诊断方面。在此类病例中，术前放射学诊断只有在出现提示性征象时才能怀疑，这些征象更多通过超声或计算机断层扫描显示。剖腹手术时，建议对整个回肠进行仔细探查，因为有可能发现其他异位节段。
