Jha Saroj Kumar, Ghimire Sharmila, Koirala Dinesh Prasad
Maharajgunj Medical Campus, Institute of Medicine, 44600, Kathmandu, Nepal.
Pediatric Surgery Unit, Tribhuvan University Teaching Hospital, Institute of Medicine, 44600, Kathmandu, Nepal.
Ann Med Surg (Lond). 2021 Aug 17;69:102723. doi: 10.1016/j.amsu.2021.102723. eCollection 2021 Sep.
Meckel's diverticulum (MD) is the most common congenital anomaly of the gastrointestinal system. It is caused by an incomplete obliteration of the vitelline duct. Rarely, it can present with complications like torsion and gangrene formation.
A 13-year previously healthy girl presented with sudden onset periumbilical pain and bilious vomiting who was subsequently diagnosed with Meckel's diverticulum. Intraoperatively, torsed gangrenous diverticulum forming band adhesion was found. Resection of Meckel's diverticulum along with gangrenous ileal segment followed by ileoileal anastomosis was done.
Axial torsion of Meckel's diverticulum with gangrene formation is a rare occurrence. Mesodiverticular band adhesion along with herniation of small bowel segments under it endangers viability of herniating segments. Preoperative diagnosis of complicated MD is difficult as it mimics other common acute abdominal conditions. CT scan and enteroclysis are imaging modalities of choice. Surgical resection of MD along with resection and anastomosis of gangrenous bowel segment results in complete cure.
Meckel's diverticulum with complications should be kept in the differential of acute abdominal conditions presenting with atypical symptoms. Surgical resection ensures complete cure.
梅克尔憩室（MD）是胃肠道最常见的先天性异常。它是由卵黄管未完全闭塞引起的。很少情况下，它会出现扭转和坏疽形成等并发症。
一名13岁此前健康的女孩出现突发脐周疼痛和胆汁性呕吐，随后被诊断为梅克尔憩室。术中发现扭转坏疽的憩室形成带状粘连。进行了梅克尔憩室切除以及坏疽性回肠段切除，随后进行回肠-回肠吻合术。
梅克尔憩室轴向扭转并形成坏疽是一种罕见情况。憩室系膜带粘连以及其下方小肠段疝出会危及疝出段的活力。复杂梅克尔憩室的术前诊断困难，因为它与其他常见的急性腹部疾病相似。CT扫描和小肠灌肠造影是首选的影像学检查方法。梅克尔憩室手术切除以及坏疽肠段切除和吻合可实现完全治愈。
有并发症的梅克尔憩室应列入伴有非典型症状的急性腹部疾病的鉴别诊断中。手术切除可确保完全治愈。
