Departments of Surgery and Pediatrics, New York City Health+ Hospitals, New York Medical College Academic, Valhalla, NY, USA.
Metropolitan Hospital, New York, NY, USA.
Am Surg. 2023 Jun;89(6):2904-2906. doi: 10.1177/00031348211060431. Epub 2022 Mar 18.
Meckel's diverticulum is commonly symptomatic the first 2 years of life. Complications associated with Meckel's diverticulum are due to gastrointestinal (GI) bleeding or obstruction. A 5-day-old male presented to the emergency department (ED) with an episode of bright red blood per rectum (BRBPR) associated with emesis. Vital signs were normal and abdomen soft and non-distended. Serial abdominal radiographs progressed to show distention of small bowel and air fluid levels. Operative intervention was undertaken with diagnosis of intestinal obstruction. On exploratory laparotomy, 24 cm of a fibrosed, ischemic closed-loop ileal segment densely adherent to the tip of a Meckel's diverticulum was identified and resected, followed by primary reanastamosis. Histologic findings confirmed ectopic gastric tissue. Symptomatic Meckel's diverticulum is often secondary to intestinal obstruction and hematochezia, findings which are caused by incarcerated inguinal hernia or ileocolic intussusception. Our patient presented with a closed loop, which has not been previously reported.
梅克尔憩室通常在生命的前 2 年出现症状。与梅克尔憩室相关的并发症是由于胃肠道 (GI) 出血或梗阻引起的。一名 5 天大的男性因直肠鲜红色血液 (BRBPR) 伴呕吐到急诊科就诊。生命体征正常，腹部柔软且无膨胀。连续的腹部 X 光片显示小肠扩张和气液平面。手术干预诊断为肠梗阻。在剖腹探查术中，发现 24 厘米长的纤维性、缺血性闭襻回肠段与梅克尔憩室的尖端紧密粘连，并进行了切除和一期吻合。组织学检查证实为异位胃组织。有症状的梅克尔憩室通常继发于肠梗阻和血便，这是由腹股沟疝嵌顿或回肠结肠套叠引起的。我们的患者表现为闭襻，这之前尚未有报道。
