Miyata Shin, Bliss David W
Children's Hospital Los Angeles, 4650 W Sunset Blvd, Los Angeles, CA, 90027, USA.
Arrowhead Regional Medical Center, 400 N Pepper Ave, Colton, CA, 92324, USA.
Surg Case Rep. 2016 Dec;2(1):67. doi: 10.1186/s40792-016-0196-8. Epub 2016 Jun 29.
Meckel's diverticulum is the most common anomaly of the gastrointestinal tract. It is usually asymptomatic, but approximately 4 % present with complications such as bleeding, intestinal obstruction, and inflammation, while perforation is rare. Carcinoid or gastrointestinal stromal tumors are occasionally found in the resected specimens of Meckel's diverticulum, particularly in the context of perforation.
A 62-year-old male with a recent history of admission and evaluation for hematochezia presented with abdominal pain. His physical examination was consistent with peritonitis. Results of laboratory testing were significant for white blood cell count of 32,000/μL. CT scan of the abdomen revealed pneumoperitoneum. During the exploratory laparotomy, perforated Meckel's diverticulum was encountered and segmental bowel resection was performed. Histological examination findings were compatible with gastrointestinal stromal tumor within Meckel's diverticulum.
While gastrointestinal stromal tumor is a rare finding in Meckel's diverticula, the potential for the coexistence of this and other tumors suggests that segmental resection of the small bowel should be considered in the treatment of perforated Meckel's diverticulum.
梅克尔憩室是胃肠道最常见的先天性异常。它通常无症状，但约4%会出现诸如出血、肠梗阻和炎症等并发症，而穿孔则罕见。类癌或胃肠道间质瘤偶尔在梅克尔憩室的切除标本中发现，尤其是在穿孔的情况下。
一名62岁男性近期因便血入院评估，现出现腹痛。他的体格检查符合腹膜炎表现。实验室检查结果显示白细胞计数为32,000/μL，具有显著意义。腹部CT扫描显示气腹。在剖腹探查术中，发现了穿孔的梅克尔憩室，并进行了肠段切除术。组织学检查结果与梅克尔憩室内的胃肠道间质瘤相符。
虽然胃肠道间质瘤在梅克尔憩室中是罕见发现，但这种肿瘤与其他肿瘤共存的可能性表明，在治疗穿孔性梅克尔憩室时应考虑行小肠段切除术。
