摘要
目的 探讨成人Meckel憩室并发症的临床特点 ,诊断和治疗。方法 回顾性分析急诊手术的 2 9例成人Meckel憩室的临床资料。结果 18～ 30岁的患者占 79.3%。憩室出血 12例(41.4% ) ,急性化脓性憩室炎 9例 (31.0 % ) ,憩室穿孔 6例 (2 0 .7% ) ,憩室致肠梗阻 2例 (6.9% )。术前经小肠造影结合99mTcO4 r核素扫描明确诊断 4例 (13.8% ) ,误诊 2 5例 (81.2 % )。 2 9例均行手术治疗 ,2 8例治愈 ,1例死亡。结论 成人Meckel憩室并发症容易误诊为阑尾炎等疾病。对下腹疼痛病人 ,尤其是年轻患者 ,若有下消化道出血 ,应想到Meckel憩室的可能性。小肠造影结合核素扫描是诊断憩室及憩室出血的有效方法。有并发症的Meckel憩室应尽早手术 。
Objective To investigate the clinical features,diagnosis and treatment of the complications of Meckel's diverticulum in adults. Methods The clinical data of 29 cases of complications in Meckel's diverticulum in adults were analysed retrospectively. Results In this series, 79.3% of the patients aged from 18 to 30years. Bleeding of diverticulum presented in 12 patients(41.4%), diverticulitis in 9 (31.0%), perforation in 6 (20.7%),and ileu caused by diverticulum in the other 2 cases.Before the operation,definite diagnosis was made on 4 cases(13.8%) by barium meal radiography and 99mTcO 4-r imaging.The other 25 patients (81.2%) were misdiagnosed.Surgical treatment was performed on all 29 patients. Twenty-eight patients cases were cured and 1 died. Conclusions The complications in Meckel's diverticulum in adults are often misdiagnosed as appendicitis etc. Barium meal radiography and 99mTcO 4-r imaging are effective methods in diagnosing diverticulum with bleeding. The patient with complications in Meckel's diverticulum should be treated by surgery as early as possible.The choice of surgery depends on pathological conditions of the patients.
出处
《中国普通外科杂志》
CAS
CSCD
2003年第4期268-270,共3页
China Journal of General Surgery
