Robbins Keenan J, Kooperkamp Hannah Z, Corsetti Ralph L
The University of Queensland Faculty of Medicine, Ochsner Clinical School, New Orleans, LA.
Department of Surgery, Ochsner Clinic Foundation, New Orleans, LA.
Ochsner J. 2019 Summer;19(2):166-168. doi: 10.31486/toj.17.0114.
Meckel diverticulum is the most common congenital gastrointestinal malformation, but it is rarely symptomatic. Peritoneal encapsulation is a rare abnormality of embryonic development and may present with obstruction, although it too is usually asymptomatic. We report the case of an 82-year-old male who presented with symptoms and imaging findings consistent with small bowel obstruction. During laparotomy, a peritoneal encapsulation was observed containing the majority of the small bowel. A Meckel diverticulum was discovered tethered to the small bowel mesentery by a mesodiverticular band, preventing egress from the accessory peritoneal membrane and appearing to be the cause of the obstruction. This patient had 3 rare findings-peritoneal encapsulation, Meckel diverticulum, and a mesodiverticular band-contributing to cause an acute small bowel obstruction. The presence of all of these features in one patient is extremely rare, and we believe this is the first description of such a phenomenon.
梅克尔憩室是最常见的先天性胃肠道畸形，但很少有症状。腹膜包裹是一种罕见的胚胎发育异常，可能会导致肠梗阻，不过通常也无症状。我们报告一例82岁男性患者，其症状和影像学表现符合小肠梗阻。在剖腹手术中，观察到一个腹膜包裹，其中包含大部分小肠。发现一个梅克尔憩室通过憩室系膜带附着于小肠系膜，阻碍了从小腹膜的流出，似乎是梗阻的原因。该患者有3个罕见表现——腹膜包裹、梅克尔憩室和憩室系膜带——共同导致了急性小肠梗阻。一名患者同时存在所有这些特征极为罕见，我们认为这是对这种现象的首次描述。
