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[儿童梅克尔憩室]

[Meckel's diverticulum in children].

作者信息

Antoshkina E P, Velichko S D, Tsvynda V D

出版信息

Khirurgiia (Mosk). 1995(4):14-6.

PMID:7674599
Abstract

In 1978-1988 operations were performed on 92 children: 35 with diverticulitis, 7 with intestinal intussusception, 5 with hemorrhage from an ulcer of the diverticulum, 13 with strangulation or mechanical ileus, 2 with strangulated Littre's hernia, one with torsion of the omentum, 22 with secondary diverticulitis, and in 7 children Meckel's diverticulum was a chance finding during other operations in the cavities. Boys accounted for 60.9' (56) of cases. There were 12 children under one year of age, nine from 1 to 3 years, 17 from 3 to 5 years, 17 from 5 to 7 years, and 12 children aged from 7 to 10 years. The clinical manifestations depended on the pathological changes developing in Meckel's diverticulum. A clinical picture of acute appendicitis developed in diverticulitis, six children had a typical picture of intussusception, and one child had a picture of acute abdomen. Anemia and a stool with dark blood were encountered in hemorrhage from a diverticular ulcer. Seven out of 13 children with ileus had a pronounced clinical picture, in the remaining 5 it was unclear and resembled that of acute appendicitis. Meckel's diverticulum was suspected before the operation in 17 (9.95%) patients. The Volkovich-Dyakonov laparotomy approach was used in 64 children, a pararectal incision in 9, a transrectal incision in 15, a median incision in one patient, hernio-laparotomy was conducted in one and Shpizi's operation in 2 children. Diverticulectomy was accomplished by the oblique-transverse method in 79 children, by the wedge techniques in 5, by the purse-string method in 2 patients, and resection of the intestine with the diverticulum was conducted in 5 children.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

1978年至1988年期间,对92名儿童进行了手术:35例患有憩室炎,7例患有肠套叠,5例患有憩室溃疡出血,13例患有绞窄性肠梗阻或机械性肠梗阻,2例患有绞窄性Littre疝,1例患有大网膜扭转,22例患有继发性憩室炎,7例儿童在其他腹腔手术中偶然发现了梅克尔憩室。男孩占病例的60.9%(56例)。1岁以下儿童12例,1至3岁9例,3至5岁17例,5至7岁17例,7至10岁12例。临床表现取决于梅克尔憩室内发生的病理变化。憩室炎时出现急性阑尾炎的临床表现,6名儿童有典型的肠套叠表现,1名儿童有急腹症表现。憩室溃疡出血时出现贫血和黑便。13例肠梗阻患儿中有7例临床表现明显,其余5例不明确,类似急性阑尾炎。17例(9.95%)患者术前怀疑有梅克尔憩室。64名儿童采用Volkovich-Dyakonov剖腹术入路,9名采用直肠旁切口,15名采用经直肠切口,1名患者采用正中切口,1名进行疝剖腹术,2名儿童采用Shpizi手术。79名儿童采用斜横法进行憩室切除术,5名采用楔形技术,2名采用荷包缝合法,5名儿童进行了带憩室的肠切除术。(摘要截取自250字)

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