Mitchell A W, Spencer J, Allison D J, Jackson J E
Department of Imaging, Imperial College of Science, Technology and Medicine, Hammersmith Hospital, London, United Kingdom.
AJR Am J Roentgenol. 1998 May;170(5):1329-33. doi: 10.2214/ajr.170.5.9574611.
The purpose of this study was to assess the sensitivity of angiography in revealing the vitellointestinal artery or other arteriographic abnormalities in patients in whom surgery subsequently proved Meckel's diverticulum.
From the 36 patients who had undergone a Meckel's diverticulectomy between 1980 and 1997 at Hammersmith Hospital or a referring hospital, we selected 18 who had undergone preoperative angiography at our institution. Case notes and angiograms of these 18 patients were reviewed for the presence of a persistent vitellointestinal artery or other angiographic evidence of a Meckel's diverticulum.
Angiograms of 16 of 18 patients were available for review. A striking male preponderance existed (male:female = 13:3). Mean age was 28 years (range, 12-65 years). In 11 (69%) of the 16 patients, a persistent vitellointestinal artery was seen that had been noted at the time of the study and reported before surgery for nine patients. Other angiographic abnormalities at the site of the Meckel's diverticulum were present in four patients and included a vascular blush, early venous return, and arterial irregularity.
Angiography will show a persistent vitellointestinal artery in most individuals with a Meckel's diverticulum who present with chronic gastrointestinal bleeding. However, the recognition of a persistent vitellointestinal artery may be difficult because of overlying vessels, and superselective catheterization of distal ileal arteries may be necessary.
本研究的目的是评估血管造影术在揭示卵黄肠管动脉或其他动脉造影异常方面的敏感性,这些异常在随后手术证实为梅克尔憩室的患者中存在。
从1980年至1997年在哈默史密斯医院或转诊医院接受梅克尔憩室切除术的36例患者中,我们选择了18例在我们机构接受术前血管造影的患者。回顾这18例患者的病历和血管造影片,以寻找是否存在持续的卵黄肠管动脉或其他梅克尔憩室的动脉造影证据。
18例患者中有16例的血管造影片可供回顾。存在明显的男性优势(男:女 = 13:3)。平均年龄为28岁(范围12 - 65岁)。在16例患者中的11例(69%)中,可见持续的卵黄肠管动脉,其中9例在研究时已被注意到并在手术前报告。4例患者在梅克尔憩室部位存在其他动脉造影异常,包括血管染色、早期静脉回流和动脉不规则。
血管造影术将在大多数因慢性胃肠道出血而就诊且患有梅克尔憩室的个体中显示持续的卵黄肠管动脉。然而,由于上方血管的存在,识别持续的卵黄肠管动脉可能困难,可能需要对回肠远端动脉进行超选择性插管。