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梅克尔憩室继发小肠梗阻:一种罕见的并发症。

Small Bowel Obstruction Secondary to Meckel's Diverticulum: A Rare Complication.

作者信息

Patel Sima, Gillett Ceri, Elgaddal Sanaa

机构信息

Surgery, New Cross Hospital, Wolverhampton, GBR.

General Surgery, Royal Stoke University Hospital, Stoke, GBR.

出版信息

Cureus. 2024 Nov 1;16(11):e72826. doi: 10.7759/cureus.72826. eCollection 2024 Nov.

Abstract

Appendicitis is defined as an inflammation of the appendix and is one of the most common presentations to the general surgical team. The presence of right iliac fossa pain associated with a rise in inflammatory markers raises the suspicion of appendicitis in young, healthy patients. Colitis and bowel obstruction would be considered lower down on the list of differentials. Other common differentials to take into consideration include ovarian pathology and pelvic inflammatory disease in females and diverticulitis in the other population. Investigation for these patients includes ultrasound scans, computed tomography, magnetic resonance imaging or diagnostic laparoscopy. Imaging modality can help narrow down differentials; however, diagnostic laparoscopy can prove to be fruitful when there is diagnostic uncertainty.  Meckel's diverticulum is commonly encountered within general surgery, more so within the paediatric population. Complications include bleeding, inflammation and obstruction, although this is less common in the adult population.  We present a rare case of small bowel obstruction with the transition point noted to be at the location of a Meckel's diverticulum masquerading as possible appendicitis.

摘要

阑尾炎定义为阑尾的炎症,是普通外科团队最常见的诊治病例之一。在年轻健康的患者中,右下腹疼痛伴有炎症标志物升高会引发阑尾炎的怀疑。结肠炎和肠梗阻在鉴别诊断清单中会被排在较靠后的位置。其他需要考虑的常见鉴别诊断包括女性的卵巢病变和盆腔炎以及其他人群的憩室炎。对这些患者的检查包括超声扫描、计算机断层扫描、磁共振成像或诊断性腹腔镜检查。成像方式有助于缩小鉴别诊断范围;然而,当存在诊断不确定性时,诊断性腹腔镜检查可能会很有成效。梅克尔憩室在普通外科中很常见,在儿科人群中更是如此。并发症包括出血、炎症和梗阻,不过在成人中这种情况不太常见。我们报告了一例罕见的小肠梗阻病例,其梗阻转折点位于一个伪装成可能阑尾炎的梅克尔憩室处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7de3/11608420/2c2754fccf0d/cureus-0016-00000072826-i01.jpg

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