Abbas Syed Hussain, Akbari Khalid, Mason John, Booth Michael
Royal Berkshire Hospital, Reading, Berkshire, UK.
BMJ Case Rep. 2016 Apr 8;2016:bcr2016214830. doi: 10.1136/bcr-2016-214830.
Meckel's diverticulum (MD) is the commonest congenital anomaly of the small intestine, affecting 1-4% of the population. Cardinal features emphasise an antimesenteric location two feet proximal to the ileocaecal valve, with a separate mesenteric blood supply and involvement of all layers of the small intestine. However, reports of MD arising from the mesenteric border of the small intestine are rare in the surgical literature. This report examines the case of a 45-year-old woman presenting with a 6-month history of episodic central abdominal pain and microcytic anaemia who underwent an elective diagnostic laparoscopy as initial CT findings were inconclusive. Intraoperatively, she was found to have small bowel intussusception approximately 40 cm proximal to the ileocaecal valve. Macroscopic examination of the resected small bowel segment revealed a mesenteric outpouching that was confirmed as mesenteric MD on histopathological analysis. Postoperatively, the patient recovered with no surgical complications and full symptom resolution.
梅克尔憩室(MD)是小肠最常见的先天性异常,影响1% - 4%的人群。主要特征为位于回盲瓣近端两英尺处的肠系膜对侧位置,有独立的肠系膜血液供应且累及小肠全层。然而,小肠系膜缘起源的MD在外科文献中报道较少。本报告探讨了一名45岁女性的病例,该患者有6个月发作性中腹部疼痛和小细胞贫血病史,因初始CT检查结果不明确而接受了选择性诊断性腹腔镜检查。术中发现她在回盲瓣近端约40厘米处发生小肠套叠。对切除的小肠段进行宏观检查发现一个系膜憩室,经组织病理学分析证实为系膜梅克尔憩室。术后,患者康复,无手术并发症,症状完全缓解。