Yu Haibo, Song Hongliang, Cai Jing
Department of Hepatobiliary Surgery, Wenzhou Central Hospital, China.
Wenzhou Central Hospital.
Rev Esp Enferm Dig. 2017 Apr;109(4):315. doi: 10.17235/reed.2017.4522/2016.
Meckel diverticulum (MD) is a common small intestinal malformation. The difficulty of MD with hemorrhage treatment lies in preoperative diagnosis. Wireless capsule endoscopy (WCE) and double-balloon enteroscopy (DBE) have been widely used to diagnose and treat diseases of the small intestine, but only rarely have they been used in combination to diagnose and treat bleeding MD. We successfully diagnosed and treated a patient with MD with hemorrhage with a combination of WCE, DBE, and laparoscopy. A 17-year-old man presented to the emergency room with hematochezia and was admitted for testing. Abdominal computed tomography, gastroscopy, and colonoscopy did not reveal hemorrhage, but WCE showed MD combined with ulceration. DBE was conducted to confirm the presence of the lesion and showed MD combined with ulceration 1 m proximal to the ileocecal valve. The patient underwent emergency laparoscopic surgery, which confirmed MD. The patient recovered well after the operation.MD with hemorrhage poses diagnostic and therapeutic challenges and can be missed on examination using standard modalities. Laparoscopy combined with WCE and DBE can be efficacious in the treatment of MD with hemorrhage.
梅克尔憩室（MD）是一种常见的小肠畸形。MD合并出血的治疗难点在于术前诊断。无线胶囊内镜（WCE）和双气囊小肠镜（DBE）已被广泛用于诊断和治疗小肠疾病，但它们联合用于诊断和治疗出血性MD的情况却很少见。我们成功地联合使用WCE、DBE和腹腔镜对一名MD合并出血的患者进行了诊断和治疗。一名17岁男性因便血就诊于急诊室并入院检查。腹部计算机断层扫描、胃镜和结肠镜检查均未发现出血，但WCE显示MD合并溃疡。进行DBE以确认病变的存在，结果显示在回盲瓣近端1米处有MD合并溃疡。患者接受了急诊腹腔镜手术，术中证实为MD。术后患者恢复良好。MD合并出血带来了诊断和治疗方面的挑战，使用标准检查方式可能会漏诊。腹腔镜联合WCE和DBE在治疗出血性MD方面可能有效。
