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在成年人中呈现为复发性胃肠道出血的症状Meckel's Diverticulum
Abishek Hariharan1, Shefali Amin1, Salina Munankami2
1Internal Medicine, Tower Health Medical Group, West Reading, USA.
Cureus
|August 14, 2023
概括
一名51岁男性的胃肠道循环出血被成功诊断为梅克尔分流器. 这一案例强调在持续出血的情况下考虑梅克尔的分流器,即使经过广泛的治疗.
科学领域:
- 胃肠病学 胃肠病学
- 手术病理学手术病理学
背景情况:
- 复发性胃肠道出血 (GIB) 构成了诊断挑战,通常需要进行广泛的调查.
- 标准的内镜手术,如食管胃管腺镜检查 (EGD),结肠镜检查和视频囊内镜检查 (VCE),可能无法识别出血源.
研究的目的:
- 为了突出麦克尔扫描在模糊GIB的情况下的诊断实用性.
- 强调在患有持续,不明原因出血的患者中考虑梅克尔分流器的重要性.
- 举一个例子,VCE未能检测到梅克尔的分流器.
主要方法:
- 一名51岁的男性患有持续性血,接受了全面的诊断检查.
- 诊断成像包括食管胃管腺镜检查 (EGD),结肠镜检查,视频囊内镜检查 (VCE),以及梅克尔扫描.
- 鉴定出异常的手术切除,其次是组织病理学检查.
主要成果:
- 最初的EGD,结肠镜和VCE并没有揭示复发性胃肠道出血的来源.
- 麦克尔扫描显示了小肠的异常吸收,表明麦克尔的分泌体与宫外胃粘膜.
- 手术病理学证实了梅克尔分管与胃异质的存在.
结论:
- 在对复发性胃肠道出血的差异诊断中,应该考虑梅克尔的分流器,特别是当初始内镜评估没有确定性时.
- 梅克尔扫描是一个有价值的工具,用于诊断症状患者的梅克尔分离器.
- 视频囊内镜可能并不总是检测到梅克尔,需要替代的诊断方法.
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