Evan Cecilia, Christy Kezia, Hanafi Ricarhdo Valentino, Rodjak Maman Wastaman
Department of General Surgery, Universitas Padjadjaran, Bandung, Indonesia.
Digestive Surgery Division, Department of General Surgery, Santo Yusup General Hospital, Bandung, Indonesia.
Heliyon. 2024 Apr 30;10(9):e30514. doi: 10.1016/j.heliyon.2024.e30514. eCollection 2024 May 15.
and Importance: Meckel's diverticulum is a rare congenital condition often detected incidentally. Meckel's diverticulum, a rare disease, may result in acute intestinal obstruction and is frequently misdiagnosed. This study aims to report a case of acute intestinal obstruction due to Meckel's diverticulum.
A 61-year-old Javanese man was admitted to the emergency room with a history of constipation, nausea, vomiting, and abdominal pain. Physical examination showed abdomen distention, tenderness in the lower quadrant, and hyperactive bowel sound. Rectal examination found that the rectal ampulla was collapsed. A plain abdominal Radiograph showed small bowel dilatation and air-fluid levels. The patient was diagnosed with small bowel obstruction due to suspected left-sided colon cancer and taken up for exploratory laparotomy.
On exploration, Meckel's diverticulum measuring 3.5 cm in length and with a 2 cm base was found about 70 cm proximal to the Bauhin valve; the thin part formed a band that entangled the small bowel. Ileo-ileal resection anastomosis was performed.
Meckel's diverticulum is an intestinal pouch caused by incomplete obliteration of the vitelline duct during gestation. This condition affects 2 % of the population and is within 2 feet of the Bauhin valve. The mesodiverticular band was found to be the source of the bowel obstruction. Surgical resection is required for complicated diverticulum.
Meckel's diverticulum can be difficult to diagnose and require a higher level of suspicion. Although Meckel's diverticulum is uncommon in adults, it should be considered a cause of small bowel obstruction.
及重要性：梅克尔憩室是一种罕见的先天性疾病，常为偶然发现。梅克尔憩室这种罕见疾病可能导致急性肠梗阻，且常被误诊。本研究旨在报告一例因梅克尔憩室导致急性肠梗阻的病例。
一名61岁的爪哇男子因便秘、恶心、呕吐及腹痛病史被收入急诊室。体格检查显示腹部膨隆、下腹部压痛及肠鸣音亢进。直肠指检发现直肠壶腹空虚。腹部平片显示小肠扩张及气液平面。患者因疑似左侧结肠癌被诊断为小肠梗阻，并接受了剖腹探查术。
术中探查发现，在回盲瓣近端约70厘米处有一个长3.5厘米、基部宽2厘米的梅克尔憩室；憩室较细的部分形成一条束带，缠绕着小肠。遂行回肠-回肠切除吻合术。
梅克尔憩室是由于胚胎期卵黄管未完全闭塞所致的肠袋。此病在人群中的发病率为2%，且距回盲瓣在2英尺范围内。发现憩室系膜带是肠梗阻的病因。对于复杂的憩室需要进行手术切除。
梅克尔憩室可能难以诊断，需要更高的怀疑指数。虽然梅克尔憩室在成人中并不常见，但应将其视为小肠梗阻的一个病因。
