Talathi Saurabh, Kelly David, Anderson Scott, Vaid Yoginder, Mestre Jose
From the Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of Alabama at Birmingham.
Department of Pathology and Laboratory Medicine, Children's of Alabama.
Pediatr Emerg Care. 2020 May;36(5):e291-e294. doi: 10.1097/PEC.0000000000001388.
Meckel diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract and the most common cause of gastrointestinal bleeding in children. Although it usually follows the rule of 2's, exceptions to this rule are reported in the literature. Often asymptomatic, MD is commonly an incidental finding during surgical interventions. When symptomatic, the most common presentation of this condition is painless rectal bleeding. A myriad of other nonspecific symptoms are however possible, especially in adults, thus making this diagnosis difficult. Meckel diverticulum has been reported to mimic other abdominal pathologies like appendicitis, inflammatory bowel disease, and pancreatitis to name a few.We report a patient with acute abdomen in whom the more common causes of acute abdomen were ruled out and a diagnosis of MD was established on exploratory laparoscopy, only after he developed perforation. This report emphasizes the need for maintaining a high index of suspicion towards a possibility of a complicated MD in patients presenting with an acute abdomen, once other causes of acute abdomen are ruled out.
梅克尔憩室（MD）是胃肠道最常见的先天性异常，也是儿童胃肠道出血最常见的原因。尽管它通常遵循“2”的规律，但文献中也报道了该规律的例外情况。MD通常无症状，常在手术干预时偶然发现。有症状时，这种疾病最常见的表现是无痛性直肠出血。然而，也可能出现许多其他非特异性症状，尤其是在成年人中，因此难以做出诊断。据报道，梅克尔憩室可模仿其他腹部疾病，如阑尾炎、炎症性肠病和胰腺炎等。我们报告一例急腹症患者，在排除了更常见的急腹症病因后，仅在其发生穿孔后通过探查性腹腔镜检查确诊为MD。本报告强调，对于急腹症患者，一旦排除了其他急腹症病因，就需要高度怀疑是否存在复杂的MD。
