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急性阑尾炎与梅克尔憩室炎罕见并发:一例报告

A rare concurrence of acute appendicitis with Meckel's diverticulitis: a case report.

作者信息

Bastakoti Aashish, Khatiwada Abhikanta, Neupane Nischal, Bastakoti Roshani, Bastakoti Anish, Kc Sharada

机构信息

Department of General Surgery, Tribhuvan University Teaching Hospital, Nepal.

Department of Radiology, Tribhuvan University Teaching Hospital, Nepal.

出版信息

Ann Med Surg (Lond). 2025 Mar 5;87(3):1729-1732. doi: 10.1097/MS9.0000000000003022. eCollection 2025 Mar.

Abstract

BACKGROUND

Meckel's diverticulitis is the inflammation of Meckel's diverticulum (MD), a common congenital structural abnormality of the gastrointestinal tract. The simultaneous occurrence of Meckel's diverticulitis with acute appendicitis is extremely rare.

CASE PRESENTATION

A 17-year-old male presented with acute abdominal pain and vomiting, accompanied by tenderness in the right iliac fossa. Laboratory investigations revealed neutrophilia and an elevated leukocyte count, while ultrasound findings were consistent with acute appendicitis. The patient underwent an emergency open appendectomy, during which an inflamed appendix was removed. Incidentally, an inflamed MD was also discovered and managed conservatively.

DISCUSSION

Acute appendicitis and Meckel's diverticulitis share overlapping clinical and imaging features, making preoperative diagnosis difficult, thereby making intraoperative evaluation essential. The management of Meckel's diverticulitis varies depending on the patient's condition and clinical judgment.

CONCLUSION

Given the difficulty in preoperative diagnosis of Meckel's diverticulitis, surgeons should routinely assess for MD during appendectomies, even when acute appendicitis is confirmed. Failing to identify and manage Meckel's diverticulitis may lead to complications and adversely affect patient outcomes.

摘要

背景

梅克尔憩室炎是梅克尔憩室(MD)的炎症,梅克尔憩室是胃肠道常见的先天性结构异常。梅克尔憩室炎与急性阑尾炎同时发生极为罕见。

病例介绍

一名17岁男性因急性腹痛和呕吐就诊,伴有右下腹压痛。实验室检查显示中性粒细胞增多和白细胞计数升高,超声检查结果与急性阑尾炎相符。患者接受了急诊开放性阑尾切除术,术中切除了发炎的阑尾。偶然发现一个发炎的梅克尔憩室,并进行了保守处理。

讨论

急性阑尾炎和梅克尔憩室炎具有重叠的临床和影像学特征,术前诊断困难,因此术中评估至关重要。梅克尔憩室炎的治疗方法因患者病情和临床判断而异。

结论

鉴于梅克尔憩室炎术前诊断困难,外科医生在阑尾切除术中应常规评估是否存在梅克尔憩室,即使已确诊为急性阑尾炎。未能识别和处理梅克尔憩室炎可能导致并发症,并对患者预后产生不利影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0ee/11981367/58c19a778464/ms9-87-1729-g001.jpg

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