Llewellyn Killian J, Knaggs Michaela, Serena Thomas, Gerken Jeffrey R
General Surgery, Corewell Health Farmington Hills, Farmington Hills, USA.
Cureus. 2024 Aug 16;16(8):e67000. doi: 10.7759/cureus.67000. eCollection 2024 Aug.
We present a case of multiple abdominal pathologies occurring simultaneously, which emphasizes the importance of keeping a broad differential and evaluating each diagnosis. A 33-year-old female presented with abdominal pain, nausea, and vomiting. Her workup included computerized tomography which demonstrated acute appendicitis with concern for a closed-loop bowel obstruction. She was offered diagnostic laparoscopy with anticipation of laparoscopic appendectomy and further evaluation for the source of the bowel obstruction. At the time of surgery, a Meckel's diverticulum with acute diverticulitis was identified, in addition to an inflamed appendix. A small band near the base of the Meckel's diverticulum was found and divided. The appendix was treated with a laparoscopic appendectomy and the Meckel's diverticulum was resected. She did well in recovery and continued to do well at her follow-up appointment. This case emphasized the importance of a thorough evaluation of a patient's differential diagnosis, as it is possible for multiple pathologies to occur simultaneously.
我们报告一例同时出现多种腹部病变的病例,该病例强调了保持广泛鉴别诊断并评估每种诊断的重要性。一名33岁女性出现腹痛、恶心和呕吐症状。她的检查包括计算机断层扫描,结果显示为急性阑尾炎,并担心存在闭袢性肠梗阻。她接受了诊断性腹腔镜检查,预期进行腹腔镜阑尾切除术,并对肠梗阻的病因进行进一步评估。手术时,除了发炎的阑尾外,还发现了一个伴有急性憩室炎的梅克尔憩室。在梅克尔憩室底部附近发现并切断了一条小束带。阑尾通过腹腔镜阑尾切除术进行处理,梅克尔憩室被切除。她恢复良好,随访时情况也持续良好。该病例强调了对患者进行全面鉴别诊断评估的重要性,因为多种病变有可能同时发生。