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[儿童期梅克尔憩室。作者自身经验]

[Meckel's diverticulum in childhood. The authors' own experience].

作者信息

Marinaccio F, Romondia A, Nobili M, Niglio F, La Riccia A, Marinaccio M

机构信息

Divisione di Chirurgia Pediatrica, ASL FG/3, Foggia.

出版信息

Minerva Chir. 1997 Dec;52(12):1461-5.

PMID:9557460
Abstract

Meckel's diverticulum occurs in approximately 2 percent of the population and may present at any age. Although Meckel's diverticulum may produce an intestinal obstruction or perforation, simulating an appendicitis, hemorrhage is its most important clinical presentation. From 1989 to 1994, Meckel's diverticulum was discovered in ten children at laparotomy. Three cases were asymptomatic, representing an incidental finding at laparotomy. Of the seven symptomatic patients, four presented with bowel obstruction (intussusception), three had rectal bleeding one of whom had diverticulitis. Contrast studies--in gastrointestinal hemorrhage--were not helpful in establishing the diagnosis; colonoscopy and gastroscopy ruled out other causes of bleeding. Five of seven symptomatic patients had an intestinal resection while two a diverticulectomy after assessment that the ulcer did not require resection. No postoperative morbidity and mortality is reported in either groups. A Meckel's diverticulum found incidentally at laparotomy should be always resected as the risk of complication is high and that of resection low.

摘要

梅克尔憩室在大约2%的人群中出现,可在任何年龄发病。虽然梅克尔憩室可能导致肠梗阻或穿孔,类似阑尾炎,但出血是其最重要的临床表现。1989年至1994年期间,在剖腹手术中发现10例儿童患有梅克尔憩室。3例无症状,是剖腹手术中的偶然发现。在7例有症状的患者中,4例表现为肠梗阻(肠套叠),3例有直肠出血,其中1例患有憩室炎。胃肠道出血的造影检查对确诊没有帮助;结肠镜检查和胃镜检查排除了其他出血原因。7例有症状的患者中,5例行肠切除术,2例在评估溃疡无需切除后行憩室切除术。两组均未报告术后发病率和死亡率。在剖腹手术中偶然发现的梅克尔憩室应始终切除,因为并发症风险高而切除风险低。

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