Hadeed Andrew A H, Azar Robert R A, Azar Nabiel N A, Benninger Brion
Western University of Health Sciences, Lebanon, OR, USA.
Providence Willamette Falls, Oregon, OR, USA.
J Surg Case Rep. 2015 Mar 1;2015(3):rjv008. doi: 10.1093/jscr/rjv008.
Meckel's diverticulum is a remnant of the omphalomesenteric duct and is the most common congenital anomalies of the gastrointestinal tract. It has been known to mimic different disease states making its diagnosis difficult. Common complications consist of bleeding, intestinal obstruction and inflammation. The patient discussed in this case study was a 29-year-old Hispanic female who presented with right lower quadrant abdominal pain. A CT scan showed a normal appendix, thickened terminal ileum and a high-grade distal small bowel obstruction with a possible closed-loop obstruction. Laparoscopy revealed Meckel's diverticulum with the rare complication of torsion. The mechanism of torsion has been postulated but with little evidence. The purpose of this case report is to discuss the apparent mechanism of axial torsion secondary to the presence of a mesodiverticular band, provide visual evidence at surgery and recommend all Meckel's diverticulum associated with a mesodiverticular band be resected to prevent further complications.
梅克尔憩室是卵黄管的残余物，是胃肠道最常见的先天性异常。已知它可模仿不同的疾病状态，使其诊断困难。常见并发症包括出血、肠梗阻和炎症。本病例研究中讨论的患者是一名29岁的西班牙裔女性，表现为右下腹腹痛。CT扫描显示阑尾正常，回肠末端增厚，高位远端小肠梗阻，可能为闭袢性梗阻。腹腔镜检查发现梅克尔憩室并伴有罕见的扭转并发症。扭转机制已被提出，但证据很少。本病例报告的目的是讨论继发于憩室系膜带的轴向扭转的明显机制，提供手术中的视觉证据，并建议切除所有与憩室系膜带相关的梅克尔憩室以预防进一步的并发症。
