Bălălău C, Bacalbaşa N, Motofei I, Popa Fl, Voiculescu S, Scăunaşu R V
Rev Med Chir Soc Med Nat Iasi. 2015 Jan-Mar;119(1):162-5.
Although many people have Meckel's diverticulum, only some experience any symptoms, most under the age of 10. In adults it is usually asymptomatic but approximately 4% develop complications. Meckel's diverticulum is usually diagnosed in the first years of life and after that the risk of the complications decreases with increasing age, with no predictive factors for the development of complications. We describe the case of a 34-year-old man admitted in the emergency department with diffuse abdominal pain, nausea, flatulence and lack of transit for feces and gas. The patient had been previously operated for peritonitis due to a perforated ulcer. Clinical examination and paraclinical investigations (abdominal radiography and ultrasound) suggested the diagnosis of intestinal obstruction, probably produced by adhesions due to previous abdominal intervention. The diverticulum was resected using a linear stapler and the patient recovered without any complications. Small bowel obstruction due to Meckel's diverticulitis may be caused by entangled loop of small bowel around a fibrous cord, intussusception, volvulus, or incarceration within a hernia sac. The discovery of a Meckel's diverticulum complication in a mid thirties patient represented an intra-operatory surprise and is the peculiarity of the case.
虽然很多人有梅克尔憩室，但只有一些人会出现症状，大多数在10岁以下。在成年人中，它通常无症状，但约4%会出现并发症。梅克尔憩室通常在生命的最初几年被诊断出来，之后并发症的风险会随着年龄的增长而降低，且没有并发症发生的预测因素。我们描述了一名34岁男性的病例，他因弥漫性腹痛、恶心、腹胀以及粪便和气体无法排出而被送往急诊科。该患者此前因溃疡穿孔导致腹膜炎接受过手术。临床检查和辅助检查（腹部X线摄影和超声）提示肠梗阻的诊断，可能是由于先前腹部手术引起的粘连所致。使用线性吻合器切除了憩室，患者康复且无任何并发症。梅克尔憩室炎引起的小肠梗阻可能是由于小肠围绕纤维索形成缠绕环、肠套叠、肠扭转或疝囊内嵌顿所致。在一名三十多岁的患者中发现梅克尔憩室并发症是术中的一个意外发现，也是该病例的独特之处。
