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急诊剖腹探查发现可能的梅克尔憩室:病例报告

Emergent Laparotomy Reveals Possible Meckel's Diverticulum: A Case Report.

作者信息

O'Doherty Casey, Yan Audrey, O'Doherty Missy, Gilman Denise

机构信息

Medicine, West Virginia School of Osteopathic Medicine, Lewisburg, USA.

Emergency Medicine/Paramedics, Institute of Applied Technology, San Diego, USA.

出版信息

Cureus. 2024 Oct 14;16(10):e71498. doi: 10.7759/cureus.71498. eCollection 2024 Oct.

Abstract

Small bowel obstruction (SBO) remains the most common diagnosis encountered by general surgeons, with 70% of cases related to adhesions from previous abdominal surgeries. Less common etiologies include Crohn's disease, gallstone ileus, and Meckel's diverticulum (MD). While MD is the most common congenital anomaly of the gastrointestinal tract, it is less frequently considered as a cause in adults. Nonetheless, it remains crucial to consider MD as a potential cause of SBO in adults, especially when evaluating patients with unexplained SBO and recurrent idiopathic abdominal pain, especially in those without a history of abdominal surgery. We present a case of a 74-year-old male presenting with right upper quadrant abdominal pain, constipation, and bilious vomiting, with a presumed diagnosis of SBO and perforation, potentially attributed to MD. This case highlights the differential challenges posed by small bowel diverticula and their complications, underscoring the need for vigilance in recognizing these complications and optimizing clinical management.

摘要

小肠梗阻(SBO)仍然是普通外科医生最常遇到的诊断,70%的病例与既往腹部手术引起的粘连有关。不太常见的病因包括克罗恩病、胆结石性肠梗阻和梅克尔憩室(MD)。虽然MD是胃肠道最常见的先天性异常,但在成人中较少被视为病因。尽管如此,将MD视为成人SBO的潜在病因仍然至关重要,尤其是在评估不明原因SBO和复发性特发性腹痛的患者时,特别是那些没有腹部手术史的患者。我们报告一例74岁男性,表现为右上腹腹痛、便秘和胆汁性呕吐,初步诊断为SBO和穿孔,可能归因于MD。该病例突出了小肠憩室及其并发症带来的鉴别诊断挑战,强调了警惕识别这些并发症并优化临床管理的必要性。

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