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Giant Meckel’s diverticulum torsion that mimics adnexal pathology

机译:模仿附件病理学的巨型梅克尔憩室扭转

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摘要

Meckel’s diverticulum is a real diverticulum located at the antimesenteric portion of intestinal loops and including all layers of the intestinal wall. It is the most common congenital anomaly of the gastrointestinal tract, and its incidence is 1–3%. Many asymptomatic cases are diagnosed when complications occur. A 23-year-old female patient applied to gynaecology emergency clinic with pelvic pain complaint. Laparotomy was performed with the diagnosis of acute abdomen because the physical examination and imaging studies did not exclude tuboovary pathology. Giant Meckel’s diverticulitis and ischemic bowel loops that had been torsion were observed. Obstruction is the most common complication and generally originates from inflammation, adhesions, intussusception and omphalo-mesenteric band. In this case, it was seen that mobilized diverticulitis can be complicated without any fibrous band or adhesion to adjacent organs. This case supports that there can be torsion of bowel in free Meckel’s diverticulum. Meckel’s diverticulum settled in the pelvic region can make a clinical manifestation that is difficult to distinguish from adnexal diseases. It should be kept in mind for cases that start with pelvic pain, form adnexal pathology suspicion and cause an acute abdomen.
机译:梅克尔憩室是真正的憩室,位于肠loop的肠膜周围部分,包括肠壁的所有层。它是最常见的胃肠道先天性异常,其发生率为1-3%。当发生并发症时,许多无症状病例被诊断出来。一名23岁的女性患者因骨盆疼痛而申请妇科急诊。由于体格检查和影像学研究并未排除肾小管卵巢病理,因此开腹手术诊断为急性腹部。观察到巨人梅克尔憩室炎和缺血性肠loop已经扭转。阻塞是最常见的并发症,通常起源于炎症,粘连,肠套叠和肠系膜肠系膜。在这种情况下,可以看到动员憩室炎可以很复杂,而没有任何纤维带或不粘附于相邻器官。这个案例支持自由梅克尔憩室中可能存在肠扭转。梅克尔憩室位于骨盆区域,其临床表现难以与附件疾病区分开。对于始于骨盆疼痛,形成附件病理可疑并引起急腹症的病例,应牢记这一点。

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