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梅克尔肠石:机械性小肠不全梗阻的罕见病因。

Meckel's enterolith : a rare cause of mechanical small bowel subobstruction.

作者信息

Wauters L, Peeters K, Van Hootegem A, Goetstouwers P, Delvaux P, Callens J

机构信息

Department of Gastroenterology and Hepatology, UZ Leuven, Leuven, Belgium.

Department of General Surgery, AZ Klina, Brasschaat, Belgium.

出版信息

Acta Gastroenterol Belg. 2018 Oct-Dec;81(4):534-537.

Abstract

Meckel's diverticulum is the most common congenital gastrointestinal malformation and may present with bleeding, obstruction and diverticulitis. Symptomatic Meckel's diverticulum is associated with age <50 years, male gender, diverticular length > 2 cm and ectopic mucosa. Formation of enteroliths is a rare complication of Meckel's diverticulum and the majority of stones will remain in the diverticulum. Factors promoting enterolith formation through precipitation of calcium in the small intestinal alkaline environment include stasis as well as diverticular anatomy and histology. Mechanical obstruction due to liberation of enteroliths is even more rare and other mechanisms include intussusception, adhesions, volvulus and neoplasms. Visualization of enteroliths on plain abdominal films is challenging because not all stones are radiopaque. Surgical diverticulectomy or segmental bowel resection with anastomosis is preferred in case of complications. We present a case of mechanical small bowel sub-obstruction resulting from an expelled Meckel's enterolith.

摘要

梅克尔憩室是最常见的先天性胃肠道畸形,可表现为出血、梗阻和憩室炎。有症状的梅克尔憩室与年龄<50岁、男性、憩室长度>2 cm和异位黏膜有关。肠石形成是梅克尔憩室的一种罕见并发症,大多数结石会留在憩室内。在小肠碱性环境中通过钙沉淀促进肠石形成的因素包括淤滞以及憩室的解剖结构和组织学。肠石脱落导致的机械性梗阻更为罕见,其他机制包括肠套叠、粘连、肠扭转和肿瘤。在腹部平片上显示肠石具有挑战性,因为并非所有结石都是不透X线的。出现并发症时,首选手术切除憩室或进行肠段切除并吻合。我们报告一例因排出的梅克尔肠石导致机械性小肠不全梗阻的病例。

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