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梅克尔憩室所致内疝伴小肠梗阻:一例报告

Internal hernia with small bowel obstruction caused by Meckel's diverticulum: A case report.

作者信息

Thi Thanh Tam Bui, Ba Hong Phong Le, Nguyen Thuan Huynh, Vo Cong Nguyen Do, Thanh Toan Vo, Dinh Thanh Le

机构信息

Thong Nhat Hospital.

Nguyen Tri Phuong Hospital.

出版信息

Radiol Case Rep. 2024 Aug 28;19(11):5342-5345. doi: 10.1016/j.radcr.2024.08.022. eCollection 2024 Nov.

Abstract

We report a case of small bowel obstruction (SBO) caused by internal hernia from Meckel's diverticulum (MD). Abdominal CT scan showed an abnormal dilated blind-ending structure in continuity with the distal ileum in the right lower quadrant, suggesting Meckel's diverticulum. MPR images revealed a "double beak-sign" at the point of MD and a collapsed closed loop with mesenteric vessels converging to the diverticulum. Since the patient has no prior history of abdominal surgery, the diagnosis of internal hernia caused by Meckel's diverticulum was considered. On laparoscopic exploration, an abnormal orifice for internal hernia created by adhesion from the tip of Meckel's diverticulum to the adjacent mesentery was revealed, confirming the diagnosis. The patient was discharged after 7 days without postoperative complications. MD-associated internal hernia is a rare cause of small bowel obstruction and should be considered to avoid delay in treatment. Multidetector Computed Tomography (MDCT) is the first-line imaging modality of choice and may offer some suggestive imaging features to make an accurate preoperative diagnosis.

摘要

我们报告一例由梅克尔憩室(MD)引起的内疝导致的小肠梗阻(SBO)病例。腹部CT扫描显示右下腹有一个与回肠末端相连的异常扩张的盲端结构,提示梅克尔憩室。多平面重组(MPR)图像显示在梅克尔憩室处有“双喙征”以及一个塌陷的闭合肠袢,肠系膜血管汇聚至憩室。由于该患者既往无腹部手术史,考虑诊断为梅克尔憩室引起的内疝。在腹腔镜探查中,发现了由梅克尔憩室尖端与相邻肠系膜粘连形成的内疝异常孔口,从而确诊。患者术后7天出院,无术后并发症。梅克尔憩室相关内疝是小肠梗阻的罕见原因,应予以考虑以避免治疗延误。多层螺旋计算机断层扫描(MDCT)是首选的一线成像方式,可能提供一些提示性的成像特征以进行准确的术前诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/76c8/11401067/369c5580400a/gr1.jpg

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