Tummers W S, van der Vorst J R, Swank D J
Department of Surgery, Groene Hart Hospital, Gouda, the Netherlands.
Int J Surg Case Rep. 2016;19:8-10. doi: 10.1016/j.ijscr.2015.12.002. Epub 2015 Dec 7.
a Meckel's diverticulum is one of the most common congenital anomalies of the digestive tract. The reported lifetime complication rate is 4%, mostly due to hemorrhage, obstruction, perforation or inflammation. A symptomatic Meckel's diverticulum due to rupture after blunt abdominal trauma is very rare. We believe this case report is the first reporting a rupture of a Meckel's diverticulum after a low velocity blunt abdominal trauma and outlining the importance of a thorough and complete examination of the patient after blunt abdominal trauma.
a 17-year-old male presented with abdominal pain after blunt abdominal trauma during a soccer game. Physical examination showed signs of peritonitis in all quadrants of the abdomen. During admission the patient deteriorated with decreasing blood pressure and raising pulse rate. A CT-scan showed free abdominal fluid. Our patient was scheduled for an emergent laparotomy where a perforated Meckel's diverticulum with fecal spill was found. A segmental ileal resection was performed. Post-operative, patient developed a pneumonia and also intra-abdominal abscesses treated with percutaneous drainage. After an admission period of 17-days the patient was discharged.
perforation of a Meckel's diverticulum is rarely suspected as a cause of acute deterioration following blunt abdominal trauma. This case shows the importance of awareness of this kind of injury especially in male patients.
梅克尔憩室是最常见的消化道先天性异常之一。报道的终生并发症发生率为4%，主要原因是出血、梗阻、穿孔或炎症。因钝性腹部创伤后破裂导致的有症状梅克尔憩室非常罕见。我们认为本病例报告是首例报道低速钝性腹部创伤后梅克尔憩室破裂，并概述了钝性腹部创伤后对患者进行全面彻底检查的重要性。
一名17岁男性在足球比赛中遭受钝性腹部创伤后出现腹痛。体格检查显示腹部所有象限均有腹膜炎体征。入院期间，患者病情恶化，血压下降，脉搏加快。CT扫描显示腹腔内有游离液体。我们的患者被安排进行急诊剖腹手术，术中发现一个穿孔的梅克尔憩室并有粪便溢出。进行了部分回肠切除术。术后，患者发生肺炎，还出现腹腔内脓肿，经皮引流治疗。住院17天后患者出院。
梅克尔憩室穿孔很少被怀疑是钝性腹部创伤后急性病情恶化的原因。本病例显示了认识这种损伤的重要性，尤其是在男性患者中。
