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一名2岁男童的腹痛与呕吐:一例肠套叠合并梅克尔憩室穿孔病例

Abdominal Pain and Vomiting in a 2-Year-Old Boy: A Case of Intussusception and Perforated Meckel's Diverticulum.

作者信息

Bowman Sara, Wysong Matthew, Marzec Sarah

机构信息

Department of Pediatric Hematology-Oncology Nationwide Children's Hospital.

Department of Hospital Pediatrics Nationwide Children's Hospital.

出版信息

J Brown Hosp Med. 2025 Apr 1;4(2):54-58. doi: 10.56305/001c.129038. eCollection 2025.

Abstract

Meckel's diverticulum is a congenital anomaly that can lead to complications such as gastrointestinal bleeding, intussusception, and perforation. We present a case of a healthy 2-year-old boy who initially presented with abdominal pain, vomiting, and diarrhea, which was misdiagnosed as acute gastritis. Despite symptomatic treatment, his condition worsened with the development of intermittent abdominal pain and non-bloody diarrhea. Initial imaging, including abdominal X-ray and ultrasound, did not reveal significant findings, and the patient was discharged after rehydration. However, he returned to the hospital with worsening pain and new reddish-brown stool, prompting further evaluation. A targeted ultrasound revealed ileo-ileal intussusception, and surgical exploration confirmed a perforated Meckel's diverticulum. Histopathology confirmed acute Meckel's diverticulitis with serosal inflammation and perforation. This case underscores the rarity of complications from Meckel's diverticulum, which typically presents with painless bloody stool, but in this patient, led to both intussusception and perforation.

摘要

梅克尔憩室是一种先天性异常,可导致诸如胃肠道出血、肠套叠和穿孔等并发症。我们报告一例健康的2岁男孩,最初表现为腹痛、呕吐和腹泻,被误诊为急性胃炎。尽管进行了对症治疗,但随着间歇性腹痛和非血性腹泻的发展,他的病情恶化。包括腹部X光和超声在内的初始影像学检查未发现明显异常,患者在补液后出院。然而,他因疼痛加剧和新出现的红褐色大便再次入院,促使进一步评估。针对性超声检查显示回肠-回肠套叠,手术探查证实为梅克尔憩室穿孔。组织病理学证实为急性梅克尔憩室炎伴浆膜炎症和穿孔。该病例强调了梅克尔憩室并发症的罕见性,其通常表现为无痛性血便,但在该患者中导致了肠套叠和穿孔。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/47d2/11966758/b816bd7783cb/bhm_2025_4_2_129038_263467.jpg

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