de Nanassy Joseph, Mack David, Bettolli Marcos, Sergi Consolato M
Department of Pathology, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.
Department of Pediatric Gastroenterology, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.
J Surg Case Rep. 2022 Aug 5;2022(8):rjac355. doi: 10.1093/jscr/rjac355. eCollection 2022 Aug.
We present the finding of a diverticulum in the colonic wall of the cecum, arising in the context of ileocecal stricture in a child with Crohn disease mimicking a post-appendectomy perforated appendiceal stump. To our knowledge, a non-Meckel diverticulum in a pediatric patient with Crohn disease has not yet been reported and we examine the mechanics behind it. According to the Laplace Law, the pressure inside a container with curved walls is inversely proportional to its radius. A diverticulum forms at the point of maximum stricture and at the locus of least resistance (weakness) in the bowel wall due to the inflammatory bowel disease. The long-time interval between diagnosis of ileocecal stricture and surgery (9 months) is important to allow the formation of this diverticulum. Continued follow-up in adulthood is warranted due to an increased risk of intestinal diverticular disease and neoplasms in patients with Crohn disease.
我们报告了一名患有克罗恩病的儿童，在回盲部狭窄的情况下，盲肠结肠壁出现憩室，其表现类似阑尾切除术后穿孔的阑尾残端。据我们所知，尚未有关于小儿克罗恩病患者出现非梅克尔憩室的报道，我们对其背后的机制进行了研究。根据拉普拉斯定律，具有弯曲壁的容器内部压力与其半径成反比。由于炎症性肠病，憩室在肠壁最狭窄点和阻力最小（薄弱）部位形成。回盲部狭窄诊断与手术之间的长时间间隔（9个月）对该憩室的形成很重要。由于克罗恩病患者发生肠道憩室病和肿瘤的风险增加，因此成年后需要持续随访。
