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病例报告:术前诊断为含有胃和胰腺型黏膜的梅克尔憩室穿孔。

Case report: preoperatively diagnosed perforated Meckel's diverticulum containing gastric and pancreatic-type mucosa.

作者信息

Abizeid Georges A, Aref Hager

机构信息

International Medical Center, Jeddah, Saudi Arabia.

出版信息

BMC Surg. 2017 Apr 11;17(1):36. doi: 10.1186/s12893-017-0236-8.

Abstract

BACKGROUND

Meckel's diverticulum is the most common congenital malformation of the gastrointestinal tract, and it represents a persistent remnant of the omphalomesenteric duct. Although it mostly remains silent, its infrequent occurrence is mirrored by the paucity of large series of data on it in the literature. Hemorrhage, obstruction and inflammation are most common complications of Meckel's diverticulum. Perforation of Meckel's diverticulum is considered very rare.

CASE PRESENTATION

We present the case of a 17-year -old male, who presented to the emergency department with 1-day history of lower abdominal pain. CT of the abdomen suggested a perforated Meckel's diverticulum, which was confirmed later at the exploratory laparotomy. Perforation was due to progressive inflammation and presence of gastric and pancreatic tissue found on histopathology.

CONCLUSION

Perforation of Meckel's diverticulum is rarely suspected. Complications of Meckel's diverticulum can be difficult to diagnose, and early recognition with timely operative intervention must occur in order to provide the best outcome for these patients. This is an interesting and unusual case of Meckel's diverticulum perforation that highlights the importance of considering Meckel's diverticulum as a differential diagnosis in every patient presenting with acute abdomen.

摘要

背景

梅克尔憩室是胃肠道最常见的先天性畸形,它是卵黄管的持续残留部分。尽管它大多无明显症状,但文献中关于它的大量数据匮乏,反映出其发病率较低。出血、梗阻和炎症是梅克尔憩室最常见的并发症。梅克尔憩室穿孔被认为非常罕见。

病例介绍

我们报告一例17岁男性病例,该患者因下腹痛1天就诊于急诊科。腹部CT提示梅克尔憩室穿孔,后来在剖腹探查术中得到证实。穿孔是由于进行性炎症以及组织病理学检查发现的胃和胰腺组织所致。

结论

梅克尔憩室穿孔很少被怀疑。梅克尔憩室的并发症可能难以诊断,必须早期识别并及时进行手术干预,以便为这些患者提供最佳治疗效果。这是一例有趣且不寻常的梅克尔憩室穿孔病例,突出了在每一位出现急腹症的患者中将梅克尔憩室作为鉴别诊断的重要性。

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