Kawasaki Yuki, Shinozaki Satoshi, Yano Tomonori, Oshiro Kenichi, Morimoto Mitsuaki, Kawarai Lefor Alan, Yamamoto Hironori
Division of Gastroenterology, Department of Medicine, Jichi Medical University, Shimotsuke, Japan.
Shinozaki Medical Clinic, Utsunomiya, Japan.
Case Rep Gastroenterol. 2017 Oct 30;11(3):632-636. doi: 10.1159/000481161. eCollection 2017 Sep-Dec.
An 18-year-old man presented after undergoing multiple investigations for abdominal pain. Retrograde double-balloon enteroscopy showed a protruding red lesion in the ileum with small ulcers, approximately 75 cm proximal to the ileocecal valve, resulting in an intussusception. An inverted Meckel's diverticulum was strongly suspected. Pressure was applied to the protruding lesion using contrast medium injection after wedging the lumen with a balloon. The intussusception partially reduced, avoiding the need for emergent surgery. Endoscopic tattooing was performed to mark the lesion for subsequent resection. Elective laparoscopy-assisted surgery with minimum laparotomy revealed an inverted Meckel's diverticulum, which was resected.
一名18岁男性在接受了多项腹痛检查后前来就诊。逆行双气囊小肠镜检查显示,在回盲瓣近端约75厘米处的回肠有一个突出的红色病变,并伴有小溃疡,导致肠套叠。高度怀疑为倒转梅克尔憩室。在用球囊楔入肠腔后,通过注射造影剂对突出病变施加压力。肠套叠部分复位,避免了急诊手术的需要。进行了内镜下纹身以标记病变以便后续切除。择期腹腔镜辅助手术并辅以最小限度的剖腹手术显示为倒转梅克尔憩室,将其切除。