Faculty of Medicine, Department of Surgery, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Chulalongkorn University, Bangkok, Thailand
Faculty of Medicine, Department of Medicine, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Chulalongkorn University, Bangkok, Thailand.
BMJ Case Rep. 2024 Jan 5;17(1):e257063. doi: 10.1136/bcr-2023-257063.
Ileal diverticula can be congenital or acquired and are rare even among the already rare entity of small bowel diverticula. What has never been reported, as far as we know, is false diverticula arising within the true non-Meckelian diverticulum with mesenteric erosion causing an occult gastrointestinal bleed. We present a patient with occult gastrointestinal bleeding from a false-in-true ileal diverticulum. Multiple investigations were required to localise the bleeding site after which the patient was taken to the operating room for a laparoscopic ileocaecectomy with complete resolution of symptoms. Preoperative localisation of the bleeding site may be difficult but is critically important in occult gastrointestinal bleeding. Procedure choice for a bleeding ileal diverticulum is dictated by the distance from the ileocaecal valve and the etiopathology of the bleed.
回肠憩室可以是先天性的，也可以是后天获得的，即使在已经罕见的小肠憩室中也很少见。据我们所知，在真正的非 Meckelian 憩室中出现假性憩室并伴有肠系膜侵蚀导致隐匿性胃肠道出血的情况从未有过报道。我们报告了一例由真性回肠憩室中的假性憩室引起的隐匿性胃肠道出血的患者。在确定出血部位后，需要进行多次检查，然后将患者送往手术室进行腹腔镜回肠盲肠切除术，症状完全缓解。隐匿性胃肠道出血时，出血部位的术前定位可能很困难，但非常重要。对于有出血的回肠憩室，手术选择取决于回盲瓣的距离和出血的病因。
