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成人 Meckel 憩室穿孔酷似急性阑尾炎:一例报告并文献复习

Perforated Meckel's Diverticulum in an Adult that Resembles Acute Appendicitis: A Case Report and Review of the Literature.

作者信息

Bakhsh Noha, Banjar Mai

机构信息

Department of Internal Medicine, Division of Radiology, Faculty of Medicine, King Abdulaziz University, Rabigh, Saudi Arabia.

Medical Imaging Department, King Abdullah Medical Complex, Jeddah, Saudi Arabia.

出版信息

Curr Med Imaging. 2025;21(e15734056320557). doi: 10.2174/0115734056320557241211115403.

Abstract

BACKGROUND

Perforation is one of the rarest effects of Meckel's diverticulum and may clinically resemble acute appendicitis.

CASE REPORT

A 34-year-old woman with pain in the right iliac fossa, nausea, and vomiting for three days was brought to the emergency department. An abdominal examination indicated rebound tenderness in the area of the right iliac fossa. Abdominal ultrasound showed a heterogeneous lesion in the left iliac fossa measuring 5 cm × 3.5 cm × 4 cm with no internal vascularity. Abdominal Computed Tomography (CT) demonstrated a hypodense lesion located left of the midline of the abdomen, which was inseparable from the small bowel at the antimesenteric border. Laparoscopic exploration was performed, and an intraoperative diagnosis of perforated Meckel's diverticulum with phlegmon formation was made. The patient had an uneventful recovery.

CONCLUSION

Radiologists should be aware of the possibility of complicated Merkel's diverticulum when encountering cases of acute abdominal pain. If there is a lower abdominal inflammatory process and a normal appendix is identified, there should be a high degree of suspicion when examining the CT scan.

摘要

背景

穿孔是梅克尔憩室最罕见的并发症之一,临床表现可能类似急性阑尾炎。

病例报告

一名34岁女性因右下腹疼痛、恶心、呕吐3天被送至急诊科。腹部检查提示右下腹有反跳痛。腹部超声显示左下腹有一大小为5 cm×3.5 cm×4 cm的不均匀病变,内部无血管。腹部计算机断层扫描(CT)显示腹部中线左侧有一低密度病变,与小肠系膜对侧缘相连。行腹腔镜探查,术中诊断为梅克尔憩室穿孔伴蜂窝织炎形成。患者恢复顺利。

结论

放射科医生在遇到急性腹痛病例时应意识到复杂性梅克尔憩室的可能性。如果存在下腹部炎症过程且阑尾正常,在检查CT扫描时应高度怀疑。

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