假牙导致梅克尔憩室穿孔继发肠梗阻:病例报告和文献综述。

IF 0.7 Q4 SURGERY Surgical Case Reports Pub Date : 2024-06-21 DOI:10.1186/s40792-024-01959-x
Gaoyuan Tian, Zefeng Yuan, Ming Luo, Yujin Zhang, Bin Kong
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引用次数: 0

摘要

背景:梅克尔憩室(MD)是胃肠道最常见的先天性畸形。然而,梅克尔憩室在临床上并不多见,而异物穿孔则更为罕见。术前诊断很困难,因为往往没有足够的信息,因此通常在术中进行诊断。虽然罕见,但应将其作为误食异物患者的鉴别诊断:以下是一名 52 岁女性患者的病例,她因全身腹痛 5 天,伴有恶心和呕吐而入院。她还停止排气。炎症指标升高,计算机断层扫描(CT)显示小肠内有气液水平,回肠内有高密度物体。根据患者的情况,由于腹腔镜手术难以实施,因此改为开腹手术。术中,异物穿破了回肠末端的憩室,导致腹腔脓肿。最后,我们进行了回肠憩室切除术和回肠部分切除术。术后证实,异物是患者误食的两颗假牙:全面了解 MD 及其并发症的临床表现、影像学特征和治疗方法将有助于临床医生做出及时、准确的诊断并提供对症治疗。
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Intestinal obstruction secondary to perforation of Meckel's diverticulum caused by dentures: a case report and review of literature.

Background: Meckel's diverticulum (MD) is the most common congenital abnormality of the gastrointestinal tract. However, MD is rare in clinical practice, and perforation of a MD by a foreign body is even rarer. Preoperative diagnosis is difficult because there is often insufficient information; therefore it is usually diagnosed intraoperatively. Although rare, it should be considered as a differential diagnosis in patients who have ingested foreign bodies.

Case presentation: The following is the case of a 52-year-old female patient who was admitted because of generalized abdominal pain for 5 days, related to nausea and vomiting. She also stopped passing gas. Inflammatory indicators were elevated, and computed tomography (CT) revealed gas-liquid levels in the small intestine and high-density objects in the ileum. Based on the patient's condition, laparotomy was performed instead because the laparoscopic procedure was difficult to perform. Intraoperatively, a foreign body perforated the diverticulum of the terminal ileum, resulting in the development of an abdominal abscess. Finally, we performed resection of the ileal diverticula and partial resection of the ileum. After the surgery, it was confirmed that the foreign bodies were two dentures accidentally eaten by the patient.

Conclusion: A thorough understanding of the clinical presentation, imaging features, and treatment of MD and its complications will assist clinicians in making prompt and accurate diagnoses and providing symptomatic treatment.

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