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青春期后青少年气腹的罕见病因——梅克尔憩室穿孔:一例报告

Perforated Meckel's Diverticulum as a Rare Cause of Pneumoperitoneum in a Post-pubescent Adolescent: A Case Report.

作者信息

Beltran Fiona, Griggs Cornelia, Stetson Alyssa

机构信息

Medical School, Tufts University School of Medicine, Boston, USA.

Pediatric Surgery, Massachusetts General Hospital, Boston, USA.

出版信息

Cureus. 2024 Sep 30;16(9):e70510. doi: 10.7759/cureus.70510. eCollection 2024 Sep.

DOI:10.7759/cureus.70510
PMID:39479147
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11524641/
Abstract

Meckel's diverticulum (MD) is known to cause surgical emergencies including intussusception, obstruction, and bleeding, but rarely results in perforation with pneumoperitoneum. Symptomatic MD is rare but most commonly presents in early childhood. We report a case of a 17-year-old male who presented with peritonitis and radiographic imaging demonstrating pneumoperitoneum and inflammation near the appendix and terminal ileum. Intraoperative findings revealed a perforated MD. A perforated MD may mimic a diagnosis of complicated appendicitis in the adolescent and adult population and should be considered in the differential diagnosis of patients presenting with pneumoperitoneum and an acute surgical abdomen.

摘要

梅克尔憩室(MD)已知会引发包括肠套叠、肠梗阻和出血在内的外科急症,但很少导致气腹穿孔。有症状的MD很少见,但最常见于儿童早期。我们报告一例17岁男性患者,其表现为腹膜炎,影像学检查显示气腹以及阑尾和回肠末端附近有炎症。术中发现为MD穿孔。MD穿孔在青少年和成人中可能会被误诊为复杂性阑尾炎,对于出现气腹和急性急腹症的患者进行鉴别诊断时应考虑到这一点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46fe/11524641/406acfc0465e/cureus-0016-00000070510-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46fe/11524641/76d53be208ba/cureus-0016-00000070510-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46fe/11524641/406acfc0465e/cureus-0016-00000070510-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46fe/11524641/76d53be208ba/cureus-0016-00000070510-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46fe/11524641/406acfc0465e/cureus-0016-00000070510-i02.jpg

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本文引用的文献

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Perforated Meckel's Diverticulum and Adhesive Intestinal Obstruction in a Preterm Neonate: A Case Report.早产儿梅克尔憩室穿孔与粘连性肠梗阻:一例报告
Cureus. 2024 Mar 15;16(3):e56208. doi: 10.7759/cureus.56208. eCollection 2024 Mar.
2
Omphalomesenteric Duct Anomalies in Children: A Multimodality Overview.小儿脐肠系膜管异常:多模态综述。
Radiographics. 2021 Nov-Dec;41(7):2090-2110. doi: 10.1148/rg.2021210048.
3
Perforated mesenteric Meckel's diverticulum: Case report.穿孔性肠系膜梅克尔憩室:病例报告
Int J Surg Case Rep. 2021 Feb;79:271-274. doi: 10.1016/j.ijscr.2021.01.027. Epub 2021 Jan 15.
4
Symptomatic Meckel's Diverticulum in Pediatric Patients-Case Reports and Systematic Review of the Literature.小儿患者的症状性梅克尔憩室——病例报告及文献系统综述
Front Pediatr. 2019 Jun 26;7:267. doi: 10.3389/fped.2019.00267. eCollection 2019.
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Meckel diverticulum in children: Evaluation of macroscopic appearance for guidance in subsequent surgery.儿童梅克尔憩室:评估宏观外观以指导后续手术
J Pediatr Surg. 2016 Jul;51(7):1177-80. doi: 10.1016/j.jpedsurg.2015.08.066. Epub 2015 Sep 15.
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Spontaneous perforation of Meckel's diverticulum: a case report and review of literature.梅克尔憩室自发性穿孔:一例病例报告及文献综述
Pan Afr Med J. 2015 Apr 1;20:319. doi: 10.11604/pamj.2015.20.319.5980. eCollection 2015.
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Diverse presentations in pediatric Meckel's diverticulum: a review of 100 cases.小儿梅克尔憩室的多种表现:100例病例回顾
Pediatr Neonatol. 2014 Oct;55(5):369-75. doi: 10.1016/j.pedneo.2013.12.005. Epub 2014 Mar 28.
8
National trends in the surgical management of Meckel's diverticulum.全国范围内 Meckel 憩室的手术治疗趋势。
J Pediatr Surg. 2011 May;46(5):893-6. doi: 10.1016/j.jpedsurg.2011.02.024.
9
Meckel's diverticulum: a systematic review.梅克尔憩室:一项系统综述
J R Soc Med. 2006 Oct;99(10):501-5. doi: 10.1177/014107680609901011.
10
Meckel diverticulum: the Mayo Clinic experience with 1476 patients (1950-2002).梅克尔憩室:梅奥诊所对1476例患者的治疗经验(1950 - 2002年)
Ann Surg. 2005 Mar;241(3):529-33. doi: 10.1097/01.sla.0000154270.14308.5f.