Kitsuki H, Iwasaki K, Yoshitomi S, Matsuura Y, Natsuaki Y, Torisu M
First Department of Surgery, Kyushu University Faculty of Medicine, Fukuoka, Japan.
Surg Today. 1993;23(10):926-8. doi: 10.1007/BF00311374.
A 19-year-old woman in her 6th month of pregnancy was admitted to our hospital after passing a massive bloody stool. Romanoscopy and upper gastrointestinal panendoscopy revealed no abnormality, but a superior mesenteric arteriography demonstrated an embryonic artery with the extravasation of contrast medium in the distal end of the ileal artery. After the diagnosis of a bleeding Meckel's diverticulum had been established, an emergency operation was successfully performed. At laparotomy, a Meckel's diverticulum was found, about 70 cm toward the oral side from the ileocecal valve, and part of the ileum, including the diverticulum, was resected. Histological examination indicated that the diverticulum had a normal ileal layer with ectopic gastric mucosa and pancreatic tissue. Furthermore, multiple ulcers were observed in the adjacent ileum. Blood coagulation was observed at the site of one of these ulcers, and this was presumed to be the source of the hemorrhage.
一名怀孕6个月的19岁女性在排出大量血便后来我院就诊。乙状结肠镜检查和上消化道全内镜检查未发现异常，但肠系膜上动脉造影显示一条胚胎动脉，在回肠动脉远端有造影剂外渗。在确诊为出血性梅克尔憩室后，成功进行了急诊手术。剖腹手术时，发现一个梅克尔憩室，位于距回盲瓣向口侧约70 cm处，包括憩室在内的部分回肠被切除。组织学检查表明，憩室具有正常的回肠层，伴有异位胃黏膜和胰腺组织。此外，在相邻的回肠中观察到多个溃疡。在其中一个溃疡处观察到血液凝固，推测这就是出血的来源。
