Tatekawa Yukihiro
Department of Pediatric Surgery, Saku Central Hospital Advanced Care Center, 3400-28, Nakagomi, Saku-shi, Nagano 385-0051, Japan.
J Surg Case Rep. 2018 Mar 28;2018(3):rjy057. doi: 10.1093/jscr/rjy057. eCollection 2018 Mar.
The case of an 11-year-old boy with an orange-associated ileus in the setting of a mesodiverticular band from a Meckel's diverticulum is reported herein. Computed tomography showed a small bowel feces sign. He underwent laparoscopic-assisted surgery, and intraoperative findings revealed a Meckel's diverticulum associated with a mesodiverticular band distal to dilated small bowel. After resection of the Meckel's diverticulum and inspection of the intestinal contents proximal to the obstruction, it was apparent that undigested food material was impacted proximal to the obstruction. Upon questioning postoperatively, it was revealed that the patient ate two citrus fruits with locular membranes several days prior to his clinical presentation. It was speculated that the combination of the citrus fruit impaction with the Meckel's band led to his obstruction. He was discharged uneventfully on postoperative Day 13. It is important to avoid eating large quantities of fruit rich in fiber and also to masticate well.
本文报道了一例11岁男孩，因梅克尔憩室的中肠憩室带导致与橙子相关的肠梗阻。计算机断层扫描显示小肠粪块征。他接受了腹腔镜辅助手术，术中发现梅克尔憩室与扩张小肠远端的中肠憩室带相关。切除梅克尔憩室并检查梗阻近端的肠内容物后，明显可见未消化的食物物质在梗阻近端嵌顿。术后询问得知，患者在出现临床症状前几天吃了两个带囊膜的柑橘类水果。推测柑橘类水果嵌顿与梅克尔带共同导致了他的肠梗阻。他于术后第13天顺利出院。避免大量食用富含纤维的水果并充分咀嚼很重要。
