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一例伴有小肠梗阻的梅克尔憩室非典型病例:手术解剖、胚胎学及临床意义

An Atypical Case of Meckel's Diverticulum with Small Bowel Obstruction: Surgical Anatomy, Embryology and Clinical Implications.

作者信息

Keot K B, Rajbongshi M C, Medhi R, Barbhuiya E A, Kumar R, Borthakur D

机构信息

Department of General Surgery, Tezpur Medical College, Tezpur, Assam, India.

Department of Anatomy, All India Institute of Medical Sciences, Patna, India.

出版信息

Clin Ter. 2023 Mar-Apr;174(2):121-125. doi: 10.7417/CT.2023.2507.

Abstract

Meckel's diverticulum (MD) is the most frequent congenital anomaly of the gastrointestinal (GI) tract. Atypical presentations with life threatening complications include intestinal obstruction, intussusceptions, peritonitis, foreign body lodgement in the MD, perforated viscera etc. which require prompt diagnosis. Ectopic gastric and pancreatic tissues are found in up to half of the cases which can escalate the complications. However clinical diagnosis is not easy especially when the presentation is atypical. A high index of clinical suspicion is required to diagnose elusive MD with associated complications. Surgical resection is safe and the gold standard treatment for complicated MD. A case of Meckel's diverticulum with concomitant mesodiverticular band (MDB) in a 13 years old male child presented as intestinal obstruction to emergency department is described which was promptly managed surgically with required pre-operative investigations. The aim of this report is to make clinicians aware about a complicated MD with MDB clinically presenting as small bowel obstruction.

摘要

梅克尔憩室(MD)是胃肠道最常见的先天性异常。伴有危及生命并发症的非典型表现包括肠梗阻、肠套叠、腹膜炎、异物嵌顿于梅克尔憩室、内脏穿孔等,这些情况需要及时诊断。高达半数的病例中可发现异位胃和胰腺组织,这会使并发症加重。然而,临床诊断并不容易,尤其是当表现不典型时。诊断隐匿性梅克尔憩室及其相关并发症需要高度的临床怀疑指数。手术切除是安全的,也是复杂梅克尔憩室的金标准治疗方法。本文描述了一名13岁男性儿童,其梅克尔憩室合并憩室系膜带(MDB),以肠梗阻的形式就诊于急诊科,通过必要的术前检查后迅速接受了手术治疗。本报告的目的是让临床医生了解一种临床上表现为小肠梗阻的合并MDB的复杂梅克尔憩室。

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