Symeonidou Elissavet, Kiroplastis Konstantinos, SidiropouIou Maria S, Gkoutziotis Ioannis, Kamparoudis Apostolos
Surgery, Ippokrateio General Hospital, Thessaloniki, GRC.
Radiology, Ippokrateio General Hospital, Thessaloniki, GRC.
Cureus. 2022 Apr 5;14(4):e23846. doi: 10.7759/cureus.23846. eCollection 2022 Apr.
The clinical presentation of congenital abnormalities in adult life is a rare condition since they usually make their appearance in early childhood. A combination of two different congenital deformities is even more infrequent, a fact that might complicate the differential diagnosis of acute abdomen. This is a case report of an inflamed Meckel's diverticulum in a 16-year-old male with intestinal malrotation presented in an acute setting, and a review of the literature. The patient presented at the emergency department with an atypical abdominal pain located in the right abdomen and quite elevated inflammatory markers. Computed tomography revealed Meckel's diverticulitis in combination with intestinal malrotation, findings that were confirmed intraoperatively. A partial enterectomy with a side-to-side anastomosis was performed, and the patient was discharged uneventfully. Only a few cases of this combination have been reported in the literature till nowadays. This article indicates the importance of the computed tomography scan in the differential diagnosis of abdominal pain since it might reveal rare clinical entities and determine the further therapeutic plan. Furthermore, it is a reminder that congenital abnormalities might make their clinical appearance not only in early childhood but also in adult life, pointing out the ability of the general surgeon to deal with such cases.
先天性异常在成年期出现的临床表现是一种罕见情况,因为它们通常在儿童早期就会显现。两种不同先天性畸形同时存在的情况更为罕见,这一事实可能会使急腹症的鉴别诊断变得复杂。本文报告了一例16岁男性患者,因急性发病,患有肠旋转不良并伴有发炎的梅克尔憩室,并对相关文献进行了综述。该患者因右腹非典型腹痛和炎症指标显著升高而就诊于急诊科。计算机断层扫描显示梅克尔憩室炎合并肠旋转不良,术中证实了这些发现。进行了部分肠切除术并端端吻合,患者顺利出院。迄今为止,文献中仅报道了少数这种合并情况的病例。本文指出了计算机断层扫描在腹痛鉴别诊断中的重要性,因为它可能揭示罕见的临床病症并确定进一步的治疗方案。此外,这也提醒我们先天性异常不仅可能在儿童早期出现临床症状,也可能在成年期出现,凸显了普通外科医生处理此类病例的能力。