Alzarea Abdullah, Aljohani Alaa, Qabani Hanan, Alzahrani Ali, Sairafi Rami
General Surgery Department, Security Force Hospital, Riyadh, Saudi Arabia.
Ann Med Surg (Lond). 2022 May 18;78:103807. doi: 10.1016/j.amsu.2022.103807. eCollection 2022 Jun.
and Importance: Meckel's diverticulum band is an uncommon cause of intestinal obstruction in adults.
We report the case of a 57-year-old diabetic and hypertensive male who presented with sudden onset of vomiting and abdominal pain. Initial laboratory and imaging investigations, including an abdominal X-ray and computed tomography scan, were suggestive of an intestinal obstruction; however, these were not helpful in assigning a presumptive cause. A laparoscopic exploration was offered after a repeated abdominal X-ray showed an air-fluid level. Intraoperative findings revealed an ischemic closed loop obstructed by a fibrous band of Meckel's diverticulum. Resection and anastomosis of the bowel was performed, and the patient was discharged on day 3 post-operative with no complications.
Surgical resection performed by open or laparoscopic approach is the recommended treatment for patients with symptomatic Meckel's diverticulum. Generally, a wedge resection of the Meckel's diverticulum is performed, and occasionally part of the ileum is resected by end-to-end anastomosis, as was the case in our patient.
We believe early surgical intervention is crucial for a favorable outcome. Thus, surgeons should consider complicated Meckel's diverticulum in patients presenting with signs and symptoms of small bowel obstruction.
及重要性：梅克尔憩室带是成人肠梗阻的罕见病因。
我们报告一例57岁的男性糖尿病和高血压患者，他突然出现呕吐和腹痛。最初的实验室和影像学检查，包括腹部X线和计算机断层扫描，提示肠梗阻；然而，这些检查无助于确定可能的病因。在重复腹部X线显示气液平面后，进行了腹腔镜探查。术中发现一个缺血性闭袢被梅克尔憩室的纤维带阻塞。进行了肠切除吻合术，患者术后第3天出院，无并发症。
对于有症状的梅克尔憩室患者，推荐采用开放或腹腔镜手术切除治疗。一般来说，对梅克尔憩室进行楔形切除，偶尔像我们的患者一样，通过端端吻合切除部分回肠。
我们认为早期手术干预对于取得良好预后至关重要。因此，外科医生在出现小肠梗阻体征和症状的患者中应考虑到复杂的梅克尔憩室。
