Duran Jonah R, White Levi J, Dunn Peter M, Chang Yong S, Knauer Andrew J
General Surgery, Touro College of Osteopathic Medicine, Middletown, USA.
General Surgery, Garnet Health Medical Center, Middletown, USA.
Cureus. 2024 Sep 3;16(9):e68562. doi: 10.7759/cureus.68562. eCollection 2024 Sep.
This case report describes a patient who presented with concern for a closed-loop small bowel obstruction (SBO). During exploratory laparotomy, an area of ischemic bowel due to closed loop obstruction was resected, along with an incidentally discovered inflamed-appearing Meckel's diverticulum (MD). The resected specimen contained a well-differentiated carcinoid tumor of benign behavior with a maximum diameter of 0.6 cm, which invaded the submucosal layer (pT1b and pN0). Over the last several years, there has been a debate with little consensus regarding the proper surgical management in the case of an asymptomatic MD that is discovered incidentally during abdominal exploration. The intention of sharing this case is to underline the importance of the decision-making process in treating patients with this intraabdominal pathologic condition found incidentally at the time of surgery.
本病例报告描述了一名因疑似闭环性小肠梗阻(SBO)前来就诊的患者。在剖腹探查术中,切除了因闭环梗阻导致的缺血性肠段,同时还意外发现了外观发炎的梅克尔憩室(MD)。切除的标本中含有一个最大直径为0.6 cm、行为良性的高分化类癌肿瘤,该肿瘤侵犯了黏膜下层(pT1b和pN0)。在过去几年中,对于在腹部探查时意外发现的无症状MD的恰当手术管理存在争议,几乎没有达成共识。分享此病例的目的是强调在治疗手术时偶然发现这种腹腔内病理状况的患者时决策过程的重要性。