Almas Talal, Alsubai Abdulla K, Ahmed Danyal, Ullah Muneeb, Murad Muhammad Faisal, Abdulkarim Khadeer, Alwheibi Eissa Sultan, Alansaari Mohamed, Abdullatif Tala, Hadeed Sebastian, Khan Muhammad Omer, Alsufyani Majid, Alzadjali Enaam, Samy Arjun, Oruk Mert, Kadom Mhmod, Alhajri Fatemah Saleh, Barakat Ahmed, Alrawashdeh Maen Monketh, Said Mohammad, AlDhaheri Reem, Mansoor Emad
Royal College of Surgeons in Ireland, Dublin, Ireland.
Maroof International Hospital, Islamabad, Pakistan.
Ann Med Surg (Lond). 2022 May 7;78:103734. doi: 10.1016/j.amsu.2022.103734. eCollection 2022 Jun.
Meckel's diverticulum is a congenital anomaly that is often detected incidentally. When it presents symptomatically, it causes painless gastrointestinal bleeding. Nevertheless, in rare instances, it can cause acute intestinal obstruction, often obscuring the true clinical picture.
A 31-year-old male presented to the emergency department with a 24-h history of unremitting nausea, biliary emesis, abdominal distension, and absolute constipation. After ruling out the most common etiologies of acute bowel obstruction, radiological imaging was obtained and was suggestive of meckel's diverticulum. Laparoscopic meckel's diverticulectomy was performed, with the subsequent histopathological analysis confirming ectopic gastric tissue.
Meckel's diverticulum occurs consequent to incomplete obliteration of the vitelline or omphalomesenteric duct, which connects the developing intestines to the yolk sac. It is found in roughly 2% of the population, of which only about 4% may become symptomatic due to any number of complications. Specifically, small bowel obstruction (SBO) and diverticulitis secondary to ectopic gastric or pancreatic tissue are the most common presentations of symptomatic MD.
Although relatively rare in adults, MD should be considered in the list of differentials in patients with intussusception leading to SBO, especially on a background history unremarkable for the most common etiologies causing SBO including post-operative adhesions and hernias.
梅克尔憩室是一种先天性异常,常为偶然发现。当出现症状时,可导致无痛性胃肠道出血。然而,在罕见情况下,它可引起急性肠梗阻,常常掩盖真实的临床情况。
一名31岁男性因持续24小时的恶心、胆汁性呕吐、腹胀和完全便秘就诊于急诊科。排除急性肠梗阻的最常见病因后,进行了放射学检查,提示梅克尔憩室。实施了腹腔镜梅克尔憩室切除术,随后的组织病理学分析证实存在异位胃组织。
梅克尔憩室是由于卵黄管或脐肠系膜管未完全闭塞所致,该管将发育中的肠道与卵黄囊相连。约2%的人群中可发现梅克尔憩室,其中仅约4%可能因各种并发症而出现症状。具体而言,小肠梗阻(SBO)以及继发于异位胃或胰腺组织的憩室炎是有症状的梅克尔憩室最常见的表现形式。
尽管梅克尔憩室在成人中相对少见,但对于因肠套叠导致SBO的患者,尤其是在没有导致SBO的最常见病因(包括术后粘连和疝)的明显病史背景下,应将其列入鉴别诊断清单中。