Chauhan Abhishek, Suggett Nigel, Guest Peter, Goh Jason
Department of Gastroenterology, University Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, UK.
Department of Colorectal Surgery, University Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, UK.
Frontline Gastroenterol. 2016 Apr;7(2):118-121. doi: 10.1136/flgastro-2015-100624. Epub 2015 Oct 21.
Meckel's diverticulum (MD) is the most commonly encountered true diverticulum in the small bowel. Although overall a rare cause of gastrointestinal bleeding, it remains an important differential in a child/young adult presenting with lower gastrointestinal bleeding. We present two MD cases, one associated with brisk bleeding resulting in haemodynamic instability and the other in insidious blood loss causing symptoms of chronic iron deficiency. These cases illustrate the heterogeneous nature of the clinical picture associated with Meckel's diverticulae, a condition most gastroenterological and surgical units will encounter. We subsequently discuss the diagnostic and management dilemma Meckel's diverticulae pose and appraise the latest evidence and management strategies in this regard.
梅克尔憩室(MD)是小肠中最常见的真性憩室。尽管总体而言它是胃肠道出血的罕见原因,但在出现下消化道出血的儿童/青年成人中,它仍是一个重要的鉴别诊断。我们报告两例梅克尔憩室病例,一例伴有大量出血导致血流动力学不稳定,另一例隐匿性失血导致慢性缺铁症状。这些病例说明了与梅克尔憩室相关的临床症状的异质性,这是大多数胃肠病学和外科科室都会遇到的情况。随后,我们讨论了梅克尔憩室带来的诊断和管理难题,并评估了这方面的最新证据和管理策略。