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一例伴有肠石的梅克尔憩室穿孔病例。

A case of perforation of Meckel's diverticulum with enterolith.

作者信息

Shimagaki Tomonari, Konishi Kozo, Kawata Koto, Edahiro Keitaro, Edagawa Makoto, Takenaka Tomoyoshi, Ohmine Takahiro, Kinjo Nao, Yamaguchi Shohei, Maeda Takashi, Tsutsui Shinichi, Matsuda Hiroyuki

机构信息

Department of Surgery, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima, 730-8619, Japan.

出版信息

Surg Case Rep. 2020 Jul 6;6(1):161. doi: 10.1186/s40792-020-00926-6.

Abstract

BACKGROUND

Perforation of Meckel's diverticulum with enteroliths is a rare complication. Here, we report a case of perforation of Meckel's diverticulum with one enterolith, which could not be accurately diagnosed by preoperative computed tomography.

CASE PRESENTATION

A 16-year-old male patient with acute onset of severe abdominal pain and a localized muscle guarding in the right hypochondrium had a solitary stone detected in the right abdomen by radiography. Abdominal computed tomography revealed a saclike outpouching of the small intestine, which contained fluid levels and an enterolith, with a mesenteric inflammatory change in the right paraumbilical area. He was diagnosed with peritonitis due to appendicitis or Meckel's diverticulitis with enterolith, and emergency operation was indicated. The perforated Meckel's diverticulum was identified approximately 30 cm proximal to the ileocecal valve. The diverticulum was transected at the base and removed. The patient's postoperative course was uneventful.

CONCLUSIONS

It is crucial for clinicians to thoroughly examine patients and appropriately request investigations that consider perforation of Meckel's diverticulum as a possible diagnosis to facilitate prompt treatment.

摘要

背景

梅克尔憩室伴肠石穿孔是一种罕见的并发症。在此,我们报告一例梅克尔憩室伴一枚肠石穿孔的病例,术前计算机断层扫描未能准确诊断。

病例介绍

一名16岁男性患者,急性起病,严重腹痛,右季肋区局限性肌紧张,腹部X线检查发现右腹部有一枚孤立结石。腹部计算机断层扫描显示小肠有一个囊状突出物,内有液平及一枚肠石,右脐旁区域有肠系膜炎症改变。他被诊断为阑尾炎或梅克尔憩室炎伴肠石导致的腹膜炎,需急诊手术。在回盲瓣近端约30 cm处发现穿孔的梅克尔憩室。憩室在底部横断并切除。患者术后恢复顺利。

结论

临床医生对患者进行全面检查并适当要求进行考虑梅克尔憩室穿孔为可能诊断的检查至关重要,以便及时治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c5b3/7338335/784719030ddc/40792_2020_926_Fig1_HTML.jpg

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