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一例由梅克尔憩室轴扭转引起的腹腔内脓肿和急腹症的罕见病例。

An unusual case of intraabdominal abscess and acute abdomen caused by axial torsion of a Meckel's diverticulum.

作者信息

Yıldız İhsan, Koca Yavuz Savaş, Barut İbrahim

机构信息

Suleyman Demirel University Medical School, Department of General Surgery, Isparta, Turkey.

出版信息

Ann Med Surg (Lond). 2016 Feb 10;6:74-6. doi: 10.1016/j.amsu.2016.01.082. eCollection 2016 Mar.

Abstract

BACKGROUND

Meckel's diverticulum (MD), the most common congenital anomaly of the gastrointestinal tract, is a true diverticulum. MD is mostly seen in pediatric age groups but may be seen in adults as well. Is twice common in men than women. Surgical treatment is required in symptomatic MD patients. We present a 21-year-old female patient who was admitted with acute abdomen and underwent diverticulectomy with diagnosis of Meckel's diverticulum.

PRESENTATION OF CASE

The 21-year-old female patient was admitted to emergency service with abdominal pain, nausea and vomiting. Physical examination revealed abdominal distention, rebound tenderness and defense. Abdominal radiography revealed air-fluid levels. White blood cell count was high. In the exploration, torsion of MD was observed and diverticulectomy was performed. Histopathologic analysis indicated the presence of MD. The patient recovered without complication, and was uneventfully discharged.

DISCUSSION

MD is found in 2% of the general population. Common complications of MD include gastrointestinal bleeding, intestinal obstruction, perforation and diverticulitis. However, axial torsion of MD is a rare complication. Simple diverticulectomy is sufficient in the treatment of most MD cases; however, ileal resection may be required in some cases. Diagnosis of MD is established by histopathologic analysis.

CONCLUSION

Although MD is known as a pediatric disease, it is likely to occur in adults as well. Axial torsion of Meckel's diverticulum should be kept in mind the adults presenting with symptoms of acute abdomen.

摘要

背景

梅克尔憩室(MD)是胃肠道最常见的先天性异常,是一种真性憩室。MD多见于儿童年龄组,但也可见于成人。男性发病是女性的两倍。有症状的MD患者需要手术治疗。我们报告一名21岁女性患者,因急腹症入院,经诊断为梅克尔憩室并接受了憩室切除术。

病例介绍

该21岁女性患者因腹痛、恶心和呕吐入住急诊。体格检查发现腹胀、反跳痛和肌紧张。腹部X线检查显示气液平面。白细胞计数升高。术中观察到MD扭转,并进行了憩室切除术。组织病理学分析表明存在MD。患者康复无并发症,顺利出院。

讨论

MD在普通人群中的发生率为2%。MD的常见并发症包括胃肠道出血、肠梗阻、穿孔和憩室炎。然而,MD的轴向扭转是一种罕见的并发症。大多数MD病例的治疗简单的憩室切除术就足够了;然而,在某些情况下可能需要切除回肠。MD的诊断通过组织病理学分析确定。

结论

虽然MD被认为是一种儿科疾病,但也可能发生在成人身上。对于出现急腹症症状的成人,应考虑梅克尔憩室的轴向扭转。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e26/4761698/e0665093e96f/gr1.jpg

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