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穿孔性梅克尔憩室炎:诊断挑战与手术结果

Perforated Meckel diverticulitis: Diagnostic challenges and surgical outcomes.

作者信息

Ben Ismail Imen, Tounsi Mohamed Karim, Boujemaa Mohamed, Zenaidi Hakim, Rebii Saber, Zoghlami Ayoub

机构信息

Department of General Surgery, Trauma and Burns Center, University of Tunis El Manar, Ben Arous, Tunisia.

出版信息

Radiol Case Rep. 2024 Dec 19;20(3):1417-1421. doi: 10.1016/j.radcr.2024.11.064. eCollection 2025 Mar.

Abstract

Meckel's diverticulum, a congenital anomaly of the omphalomesenteric duct, is a rare cause of acute abdomen and poses significant diagnostic challenges due to its variable presentation and complications such as perforation. We present the case of a 19-year-old male with a 24-hour history of right iliac fossa pain progressing to generalized abdominal tenderness. Laboratory results showed leukocytosis and elevated C-reactive protein, while CT imaging suggested pneumoperitoneum and an inflamed Meckel diverticulum. Laparoscopic exploration, followed by conversion to laparotomy, confirmed a perforated Meckel diverticulum, which was resected with an uneventful recovery. This case highlights the importance of including Meckel's diverticulum in the differential diagnosis of acute abdomen in young patients, emphasizing the utility of CT imaging and the need for prompt surgical intervention to achieve favorable outcomes.

摘要

梅克尔憩室是卵黄管的先天性异常,是急性腹痛的罕见病因,因其表现多样及存在穿孔等并发症而带来重大诊断挑战。我们报告一例19岁男性病例,患者有24小时右下腹疼痛病史,后发展为全腹压痛。实验室检查结果显示白细胞增多和C反应蛋白升高,而CT成像提示气腹和发炎的梅克尔憩室。腹腔镜探查后转为开腹手术,证实为穿孔性梅克尔憩室,予以切除,术后恢复顺利。该病例强调了在年轻患者急性腹痛的鉴别诊断中纳入梅克尔憩室的重要性,凸显了CT成像的作用以及及时手术干预以取得良好预后的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3802/11728659/b980e874709b/gr1.jpg

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