Le Nguyen Thao-Tram, Nguyen Vy Thuc, Tong Huong Diu
Vinmec Nhatrang Hospital - Vinmec Healthcare System, 42A Tran Phu Street, Vinh Nguyen Ward, Nha Trang City, Khanh Hoa Province, Viet Nam.
Vinmec Nhatrang Hospital - Vinmec Healthcare System, 42A Tran Phu Street, Vinh Nguyen Ward, Nha Trang City, Khanh Hoa Province, Viet Nam.
Int J Surg Case Rep. 2024 Dec;125:110487. doi: 10.1016/j.ijscr.2024.110487. Epub 2024 Oct 22.
Meckel's diverticulum, a congenital anomaly arising from incomplete obliteration of the omphalomesenteric duct, often remains asymptomatic but can lead to complications such as diverticulitis and perforation. These complications pose significant diagnostic challenges, especially in adults, and require prompt surgical intervention to achieve optimal outcomes.
We report two cases of complicated Meckel's diverticulum in adult male patients. Case 1 was a 40-year-old presenting with atypical epigastric pain and fever, diagnosed with Meckel's diverticulitis and perforation via abdominal sonography and CT imaging instead of initial appendicitis, confirmed through laparoscopic exploration. Case 2 involved a 42-year-old with right flank pain and diarrhoea initially suspected of gastrointestinal infection. Abdominal sonography and CT led to a diagnosis of Meckel's diverticulitis, which was later confirmed and resolved through promptly laparoscopy.
Although Meckel's diverticulum predominantly affects children, these cases highlight its clinical significance in adults. The 'rule of 2s' often guides the diagnosis, yet complications can present variably, necessitating careful assessment in advanced imaging modalities. High-frequency ultrasonography and CT scans are crucial for preoperative diagnosis, guiding timely surgical interventions and improving patient outcomes.
An accurate preoperative diagnosis of Meckel's diverticulum and its single or multiple complications could be accurate preoperative diagnosed by process of high-frequency ultrasound followed by CT Scan. The probability of overlapping complications within Meckel's diverticulum scenario should be considered in differential diagnosis which requires the cautiousness of radiologists to prompt a punctual appropriate treatment.
梅克尔憩室是一种因卵黄管未完全闭塞而形成的先天性异常,通常无症状,但可导致憩室炎和穿孔等并发症。这些并发症带来了重大的诊断挑战,尤其是在成人中,需要及时进行手术干预以获得最佳治疗效果。
我们报告了两例成年男性患者的复杂性梅克尔憩室病例。病例1是一名40岁男性,表现为非典型上腹部疼痛和发热,最初被诊断为阑尾炎,经腹部超声和CT成像诊断为梅克尔憩室炎和穿孔,通过腹腔镜探查得以证实。病例2是一名42岁男性,出现右侧腰痛和腹泻,最初怀疑是胃肠道感染。腹部超声和CT检查诊断为梅克尔憩室炎,随后通过及时的腹腔镜检查得以确诊并治愈。
尽管梅克尔憩室主要影响儿童,但这些病例突出了其在成人中的临床意义。“2法则”常指导诊断,但并发症的表现可能多种多样,因此需要在先进的成像方式中进行仔细评估。高频超声和CT扫描对于术前诊断至关重要,可指导及时的手术干预并改善患者预后。
通过高频超声检查后进行CT扫描的过程,可以准确地对梅克尔憩室及其单一或多种并发症进行术前诊断。在鉴别诊断中应考虑梅克尔憩室情况下并发症重叠的可能性,这需要放射科医生谨慎行事,以便及时进行适当的治疗。