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婴儿梅克尔憩室穿孔:一例病例报告及文献复习

Perforated Meckel's Diverticulum in an Infant: A Case Report and Review of the Literature.

作者信息

Tepelenis Kostas, Kefala Maria Alexandra, Papasavva Margarita Efthalia, Gkrepi Aikaterini, Tsanaka Vasiliki, Grammeniatis Vasilios, Georgopoulou Konstantina, Kyrochristou Gerasimia D, Kyrochristou Ilektra, Gketsi Vasiliki

机构信息

Surgery, General Hospital of Ioannina G. Hatzikosta, Ioannina, GRC.

Pediatrics, General Hospital of Ioannina G. Hatzikosta, Ioannina, GRC.

出版信息

Cureus. 2025 May 29;17(5):e85066. doi: 10.7759/cureus.85066. eCollection 2025 May.

Abstract

Meckel's diverticulum (MD) is the most common congenital malformation of the gastrointestinal tract, but perforation of this diverticulum is a rare complication, especially in infants. Diagnosing this complication before surgery can be difficult, and it is typically confirmed through laparotomy. This report describes an eight-month-old female infant who was brought to the emergency department with a history of persistent crying, fever, vomiting, and one occurrence of currant jelly stool in the past 12 hours. A physical examination revealed abdominal distension, tenderness, and rigidity. An abdominal ultrasound indicated free intra-abdominal fluid containing micro-echoic elements. An exploratory laparotomy was performed, during which pus was found in the abdominal cavity. A perforated MD was identified, located 60 cm proximal to the ileocecal valve. An enterectomy and end-to-end anastomosis were performed to remove the perforated diverticulum. The postoperative course was uneventful, and the infant was discharged on the eighth postoperative day. Histopathological examination confirmed the presence of a perforated MD with ectopic gastric mucosa. This report summarizes and characterizes the presentation, diagnosis, and management of this rare complication.

摘要

梅克尔憩室(MD)是胃肠道最常见的先天性畸形,但该憩室穿孔是一种罕见的并发症,尤其在婴儿中。术前诊断这种并发症可能很困难,通常通过剖腹手术来确诊。本报告描述了一名8个月大的女婴,因持续哭闹、发热、呕吐以及在过去12小时内出现一次果酱样大便的病史被送往急诊科。体格检查发现腹胀、压痛和肌紧张。腹部超声显示腹腔内有含微回声成分的游离液体。进行了剖腹探查术,术中发现腹腔内有脓液。发现一个穿孔的梅克尔憩室,位于回盲瓣近端60厘米处。进行了肠切除术和端端吻合术以切除穿孔的憩室。术后过程顺利,婴儿在术后第8天出院。组织病理学检查证实存在伴有异位胃黏膜的穿孔梅克尔憩室。本报告总结并描述了这种罕见并发症的表现、诊断和治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/55fc/12206280/9a6f0701d795/cureus-0017-00000085066-i01.jpg

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