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腹腔镜治疗具有双基底的梅克尔憩室继发机械性小肠梗阻。一种罕见的解剖学表现。

Laparoscopic Management of Mechanical Small Bowel Obstruction Secondary to Meckel's Diverticulum with a Double Basis. A Rare Anatomic Presentation.

作者信息

Mariani Aurora, Siddiqui Mohammed, Boulard Nicolas, Berrebi Dominique, Bonnard Arnaud

机构信息

Department of Paediatric Surgery, Hopital Femme Mere Enfant, Bron, Auvergne-Rhône-Alpes, France.

Department of Pediatric Surgery, Robert-Debré Mother-Child University Hospital, Paris, Île-de-France, France.

出版信息

European J Pediatr Surg Rep. 2020 Jan;8(1):e59-e61. doi: 10.1055/s-0040-1713902. Epub 2020 Nov 23.

Abstract

Meckel's diverticulum (MD) is the most common congenital abnormality of the gastrointestinal tract. Intestinal occlusion due to MD is a commonly observed consequence of intussusception or volvulus. Here, we report a case of an 11-year-old boy who presented to the emergency department with acute abdominal pain, bilious vomiting, and abdominal rebound tenderness. Computed tomography scan concluded a diagnosis of intestinal occlusion with no apparent cause. The patient was submitted to diagnostic laparoscopy, and mechanical occlusion by the permeable Meckel with double base was identified. A diverticulectomy by staplers was performed, and occlusion was alleviated. MD is a rare disease (for only 0.3-2.9% of the general population), and only 4.2 to 9% of patients diagnosed with MD have associated complications. MD can be a large base or a narrow base, with a mesodiverticular band but the diverticulum is usually a blind recess. In our case, the tube connected two intestinal segments. To the best of our knowledge, we have reported the first case of an MD-like permeable tube with a double basis.

摘要

梅克尔憩室(MD)是最常见的胃肠道先天性异常。MD导致的肠梗阻是肠套叠或肠扭转常见的后果。在此,我们报告一例11岁男孩,因急性腹痛、胆汁性呕吐和腹部反跳痛就诊于急诊科。计算机断层扫描诊断为无明显病因的肠梗阻。患者接受了诊断性腹腔镜检查,发现由可渗透的双基底梅克尔憩室导致的机械性梗阻。采用吻合器进行了憩室切除术,梗阻得以缓解。MD是一种罕见疾病(仅占普通人群的0.3 - 2.9%),且仅4.2%至9%被诊断为MD的患者有相关并发症。MD可为宽基底或窄基底,有憩室系膜带,但憩室通常是盲端凹陷。在我们的病例中,该管道连接了两个肠段。据我们所知,我们报告了首例双基底类似MD的可渗透管道病例。

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