Hulf Toby, Ben-David Matan
Department of Surgery, Western Health, 160 Gordon Street, Footscray, VIC 3011, Australia.
Department of Surgery, Townsville University Hospital, 100 Angus Smith Dr, Douglas, QLD 4814, Australia.
J Surg Case Rep. 2023 Nov 11;2023(11):rjad613. doi: 10.1093/jscr/rjad613. eCollection 2023 Nov.
A fit and well gentleman in his 40s presented with vomiting and obstipation. His only relevant history being recent ingestion of a large quantity of mangoes. A computer tomography demonstrated a small bowel obstruction with a transition point in the right iliac fossa, but no other pathological findings. After a short period of non-operative management he proceeded to surgery, where a phytobezoar was identified at a Meckel's diverticulum causing a pantaloon shaped intra-luminal obstruction. A small bowel resection and primary anastomosis was performed and the patient had an uncomplicated post-operative course. Meckel's diverticuli are a relatively common phenomenon and may pre-dispose to bowel obstructions through a number of different mechanisms. This unusual case highlights the importance of considering this as a differential, and one that will likely require timely operative intervention.
一名40多岁身体健康的男性出现呕吐和便秘症状。他唯一相关的病史是近期大量食用芒果。计算机断层扫描显示小肠梗阻,梗阻部位在右髂窝,但无其他病理发现。经过短时间的非手术治疗后,他接受了手术,术中在梅克尔憩室发现一个植物性粪石,导致裤形腔内梗阻。进行了小肠切除和一期吻合术,患者术后恢复顺利。梅克尔憩室是一种相对常见的现象,可能通过多种不同机制导致肠梗阻。这个不寻常的病例凸显了将其作为鉴别诊断的重要性,而且很可能需要及时进行手术干预。