McGrath Adrian K, Suliman Fatimah, Thin Noel, Rohatgi Ashish
Department of General Surgery, Whipps Cross University Hospital, London, UK.
BMJ Case Rep. 2019 Sep 18;12(9):e230612. doi: 10.1136/bcr-2019-230612.
Meckel's diverticulum is the most common congenital abnormality affecting the gastrointestinal tract, affecting 4% of the general population. It is classically located on the antimesenteric border of the ileum within 100 cm of the ileocaecal valve. Complications may include haemorrhage, bowel obstruction, diverticulitis, perforation and malignancy. This report explores the case of intussusception in an adult, in association with a mesenteric Meckel's diverticulum and adjacent benign polyp. A 40-year-old man presented with acute abdominal pain, affecting the central abdomen and both flanks. CT imaging revealed small bowel intussusception, with either a Meckel's diverticulum or polyp acting as a lead point. Intraoperatively, the intussusception had already resolved; however, an inflamed outpouching was identified on the mesenteric border of the ileum, with a firm mass palpable within the bowel lumen. A 70 mm small bowel resection and primary anastomosis were performed. Histopathological analysis confirmed an inflamed Meckel's diverticulum as well as an adjacent diverticulum comprising a benign polyp.
梅克尔憩室是影响胃肠道的最常见先天性异常，在普通人群中的发生率为4%。它典型地位于回盲瓣100厘米范围内回肠的系膜对侧缘。并发症可能包括出血、肠梗阻、憩室炎、穿孔和恶性肿瘤。本报告探讨了一例成人肠套叠病例，该病例与肠系膜梅克尔憩室及相邻的良性息肉有关。一名40岁男性因急性腹痛就诊，疼痛累及中腹部和双侧胁腹。CT成像显示小肠肠套叠，以梅克尔憩室或息肉作为套叠头部。术中，肠套叠已自行复位；然而，在回肠的系膜缘发现一个发炎的憩室样突出物，肠腔内可触及一个坚实的肿块。进行了70毫米的小肠切除和一期吻合术。组织病理学分析证实为发炎的梅克尔憩室以及一个包含良性息肉的相邻憩室。
