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梅克尔憩室作为胃肠道出血的一个原因。

Meckel's diverticulum as a cause of gastrointestinal bleeding.

作者信息

Gao Cong, Chuai Shengwu, Liang Zhendong, Ye Chun, Qi Xingshun

机构信息

Gastroenterology, General Hospital of Northern Theater Command, China.

General Surgery, General Hospital of Northern Theater Command, China.

出版信息

Rev Esp Enferm Dig. 2025 Aug;117(8):485. doi: 10.17235/reed.2024.10936/2024.

Abstract

Meckel's diverticulum, the most common congenital anomaly of the gastrointestinal tract, is often asymptomatic. Lack of complete resorption of the omphalomesenteric duct is an important cause of Meckel's diverticulum. Gastrointestinal (GI) bleeding is a major complication of Meckel's diverticulum. Herein, we reported a case of obscure gastrointestinal bleeding secondary to Meckel's diverticulum in small intestine detected by double-balloon enteroscopy. A 32-year-old male was admitted to the Department of Gastroenterology due to a 4-year history of intermittent hematochezia. Half a month before this admission, abdominal computed tomography scans showed high density in intestinal tract, and magnetron capsule endoscopy showed dark red blood from the end of the ileum to the ascending colon, but did not identify the source of bleeding. At this admission, hemoglobin concentration was 117 g/L. Double-balloon enteroscopy via anal route was performed, and found a large diverticulum in the middle part of the ileum, which was marked by two metal clips, with a superficial ulcer on its inner wall. Thus, Meckel's diverticulum was diagnosed. Subsequently, he underwent surgery. During surgery, a small intestinal diverticulum with a size of about 5.0cm×2.0cm was located nearly 120cm away from the ileocecal part. Small intestinal diverticulectomy was performed. He did not develop any recurrent hematochezia during follow-up.

摘要

梅克尔憩室是胃肠道最常见的先天性异常,通常无症状。卵黄管未完全吸收是梅克尔憩室的一个重要病因。胃肠道出血是梅克尔憩室的主要并发症。在此,我们报告一例通过双气囊小肠镜检查发现的小肠梅克尔憩室继发隐匿性胃肠道出血病例。一名32岁男性因间歇性便血4年入住消化内科。此次入院前半月,腹部CT扫描显示肠道高密度影,磁控胶囊内镜显示从回肠末端至升结肠暗红色血液,但未明确出血来源。此次入院时,血红蛋白浓度为117g/L。经肛门途径行双气囊小肠镜检查,发现回肠中部有一个大憩室,用两个金属夹标记,其内壁有一个浅表溃疡。因此,诊断为梅克尔憩室。随后,他接受了手术。手术中,在距回盲部约120cm处发现一个大小约为5.0cm×2.0cm的小肠憩室。行小肠憩室切除术。随访期间他未再出现便血。

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