Wong Chee S, Dupley Leanne, Varia Haren N, Golka Darek, Linn Thu
Department of General Surgery, Blackpool Teaching Hospital NHS Foundation Trust, Blackpool, UK
Department of General Surgery, Blackpool Teaching Hospital NHS Foundation Trust, Blackpool, UK.
J Surg Case Rep. 2017 Jan 6;2017(1):rjw225. doi: 10.1093/jscr/rjw225.
Meckel's diverticulum is the most common congenital abnormality of the small intestine that results from incomplete closure of the vitelline (omphalo-mesenteric) duct. This true diverticulum, ~2 ft from the ileocecal valve commonly found on the anti-mesenteric border of the ileum, is benign and majority asymptomatic. Diagnosis challenges arise when it became inflamed or presented in following ways, for example, haemorrhage (caused by ectopic pepsin-and hydrochloric acid-secreting gastric mucosa), intestinal obstruction (secondary to intussusception or volvulus) or the presence of diverticulum in the hernia sac (Littre's hernia). We report a case of a 59-year-old male who was admitted under the surgical service at Blackpool Victoria Hospital with suspected appendicitis that turned out to be a Meckel's diverticulitis, a rare presentation of an acute abdomen. We discuss the issues involved in his investigation and management as well as perform a literature review comparing different surgical approaches.
梅克尔憩室是小肠最常见的先天性异常,由卵黄管(脐肠系膜管)未完全闭合引起。这个真性憩室通常位于回肠对系膜缘,距离回盲瓣约2英尺,是良性的,大多数无症状。当它发炎或以以下方式出现时,诊断就会面临挑战,例如出血(由异位分泌胃蛋白酶和盐酸的胃黏膜引起)、肠梗阻(继发于肠套叠或肠扭转)或疝囊内存在憩室(里特疝)。我们报告一例59岁男性患者,他因疑似阑尾炎入住布莱克浦维多利亚医院外科,结果诊断为梅克尔憩室炎,这是一种罕见的急腹症表现。我们讨论了其检查和治疗中涉及的问题,并对不同手术方法进行了文献综述比较。