Kassim Thamer, Abdussalam Abdullah, Jenkins Erin
Internal Medicine, Creighton University Medical Center, Omaha, USA.
Gastroenterology, Creighton University, Omaha, USA.
Cureus. 2018 Jun 22;10(6):e2865. doi: 10.7759/cureus.2865.
According to anecdotal reports in literature, encountering Meckel's diverticulum in a patient with Crohn's disease is not uncommon, but differentiating between the overlapping complications of Mickel's diverticulum and the natural manifestations of Crohn's disease can be challenging and may impact lifelong therapy. In this report, we present a case of Meckel's diverticulitis in a patient with stricturing ileocolonic Crohn's disease. A 29-year-old male has been suffering from recurrent bouts of abdominal pain and diarrhea which were initially thought to be due to recurrent flares of Crohn's disease. The patient was started on different medical regimens to control his disease, but complete remission was not achieved. He was found to have an inflamed Meckel's diverticulum during laparotomy with sections of transmural inflammation extending into the diverticulum with absence of heterotopic mucosa. Although Meckel's diverticulum and Crohn's disease involve separate disease processes and different pathogenesis, several hypotheses to explain a correlation have been suggested. We believe it is important to consider the presence of an inflamed Meckel's diverticulum in the differential diagnosis for patients with refractory Crohn's disease who do not have an adequate response to medical therapy.
根据文献中的轶事报道，在克罗恩病患者中遇到梅克尔憩室并不罕见，但区分梅克尔憩室的重叠并发症和克罗恩病的自然表现可能具有挑战性，并且可能影响终身治疗。在本报告中，我们展示了一例患有狭窄性回结肠克罗恩病患者的梅克尔憩室炎病例。一名29岁男性反复出现腹痛和腹泻，最初认为是由于克罗恩病反复发作所致。该患者开始接受不同的药物治疗方案来控制病情，但未实现完全缓解。在剖腹手术中发现他有一个发炎的梅克尔憩室，透壁性炎症延伸至憩室，且无异位黏膜。虽然梅克尔憩室和克罗恩病涉及不同的疾病过程和发病机制，但已经提出了几种假说来解释它们之间的相关性。我们认为，对于对药物治疗反应不佳的难治性克罗恩病患者，在鉴别诊断中考虑存在发炎的梅克尔憩室很重要。
