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在一名疑似小肠克罗恩病的儿童中诊断出梅克尔憩室。

Meckel's Diverticulum Diagnosed in a Child with Suspected Small Bowel Crohn's Disease.

作者信息

Kang Hyun Sik, Lee Jeong Sub, Hyun Chang Rim, Jung In-Ho, Kang Ki Soo

机构信息

Department of Pediatrics, Jeju National University School of Medicine, Jeju, Korea.

Department of Radiology, Jeju National University School of Medicine, Jeju, Korea.

出版信息

Pediatr Gastroenterol Hepatol Nutr. 2019 Jan;22(1):98-104. doi: 10.5223/pghn.2019.22.1.98. Epub 2019 Jan 10.

Abstract

We report a rare case of Meckel's diverticulum in a boy who initially presented with chronic iron deficiency anemia (IDA) without any history of gastrointestinal (GI) bleeding at 8 years-old. Isolated small bowel Crohn's disease was suspected based on findings of small bowel ulcers on capsule endoscopy. At four years from initial presentation, he developed massive GI bleeding. Abdominal computed tomographic angiography and small bowel series revealed findings suggestive of Meckel's diverticulum. Meckel's diverticulum should be suspected in children with unexplained chronic IDA even in the absence of prominent GI bleeding and negative findings on repetitive Meckel's scans. Moreover, Meckel's diverticulum should be included in the differential diagnosis of isolated small bowel Crohn's disease when the disease is limited to a short segment of the distal small bowel, as ulcers and inflammation may result as a consequence of acid secreted from adjacent heterotopic gastric mucosa constituting the Meckel's diverticulum.

摘要

我们报告了一例罕见的梅克尔憩室病例,患儿为一名8岁男孩,最初表现为慢性缺铁性贫血(IDA),无任何胃肠道(GI)出血病史。基于胶囊内镜检查发现小肠溃疡,怀疑为孤立性小肠克罗恩病。自初次就诊4年后,他发生了大量GI出血。腹部计算机断层血管造影和小肠造影显示出提示梅克尔憩室的表现。即使在无明显GI出血且梅克尔扫描结果为阴性的情况下,对于不明原因的慢性IDA患儿也应怀疑梅克尔憩室。此外,当孤立性小肠克罗恩病局限于远端小肠的短节段时,梅克尔憩室应纳入其鉴别诊断,因为溃疡和炎症可能是由构成梅克尔憩室的相邻异位胃黏膜分泌的酸所致。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4625/6333590/ccaf67b668eb/pghn-22-98-g001.jpg

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