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轴向扭转与坏疽:梅克尔憩室的一种罕见并发症。

Axial Torsion and Gangrene: An Unusual Complication of Meckel's Diverticulum.

作者信息

Ajmal Hassan Bin, Majid Zainab, Tahir Faryal, Sagheer Saima

机构信息

General Surgery, Dow University of Health Sciences, Karachi, PAK.

Internal Medicine, Dow University of Health Sciences, Karachi, PAK.

出版信息

Cureus. 2020 Jan 19;12(1):e6702. doi: 10.7759/cureus.6702.

Abstract

Meckel's diverticulum (MD), a congenital abnormality of the gastrointestinal tract, is usually found in the pediatric population younger than two years of age; hence, its incidence in adults is rare. Although MD is mostly clinically silent, in adults, it may present with intestinal obstruction and diverticulitis. The complications of MD include hemorrhage, perforation, enterolith formation, torsion, Littre's hernia, ulceration and neoplasm. Among these, torsion is one of the rarely reported complications of MD. MD being attached to the ileal mesentery or umbilicus, presence of mesodiverticular band, and the length, breadth and base diameter of the diverticulum contribute as a risk factor for torsion. A similar clinical picture of acute appendicitis must be excluded. We report a case of a 25-year-old male who presented with signs of intestinal obstruction in whom intraoperative finding of a torted MD with necrotic and twisted base was found upon emergency exploratory laparotomy.

摘要

梅克尔憩室(MD)是一种胃肠道先天性异常,通常见于两岁以下的儿童;因此,其在成人中的发病率很低。虽然MD在大多数情况下临床上并无症状,但在成人中,它可能表现为肠梗阻和憩室炎。MD的并发症包括出血、穿孔、肠石形成、扭转、里特疝、溃疡和肿瘤。其中,扭转是MD很少报道的并发症之一。MD附着于回肠系膜或脐部、存在憩室系膜带以及憩室的长度、宽度和基部直径是扭转的危险因素。必须排除类似急性阑尾炎的临床表现。我们报告一例25岁男性,因肠梗阻症状就诊,急诊剖腹探查术中发现一个扭转的MD,其基部坏死并扭曲。

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