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由Meckel憩室引起的消化道出血较少见,临床确诊不易。现将我院收治的3例报道如下: 1 病例介绍 例1,男,27岁。因排鲜血便(约600ml)10分钟急诊入院。不含粘液,伴有头晕、乏力、心慌等.无腹痛、腹胀。查体:BP11/7kPa,轻度贫血貌,腹软,无压痛,肠呜音亢进。血常规:Hb100g/L,WBC:10.2×10~9/L。患者既往有3次类似排血便史,每次量约400～800ml,间隔时间3个月～5年不等。均发生于患者精神极度紧张或劳累之后。曾于外院行全消化道钡餐、纤维胃镜、选择性血管造影等检查,均未发现异常。给以输血、止血、输液、抗炎等治疗。入院30分钟后再次排血便约200ml,决定剖腹探查,诊断为Meckel憩室并出血。切除憩室病理报告为Meckel憩室,可见胃粘膜组织。随访3年未复发。
Gastrointestinal bleeding caused by Meckel diverticula is rare, and clinical diagnosis is not easy. Now admitted to our hospital in 3 cases reported as follows: 1 case introduction Example 1, male, 27 years old. Due to row of blood will (about 600ml) 10 minutes emergency admission. Contains no mucus, accompanied by dizziness, fatigue, palpitation, etc. No abdominal pain, bloating. Examination: BP11 / 7kPa, mild anemia, abdominal soft, no tenderness, bowel sounds hyperthyroidism. Blood: Hb100g / L, WBC: 10.2 × 10 ~ 9 / L. In the past, there were 3 patients who had a similar history of excretion of blood, about 400 to 800 ml each time, and intervals of 3 months to 5 years. Occurred in patients with extreme mental stress or after exertion. Have outside the hospital line of digestive tract barium meal, gastroscopy, selective angiography and other tests, were found no abnormalities. Give blood transfusion, bleeding, infusion, anti-inflammatory treatment. About 30 minutes after admission, about 200 ml of blood was discharged again, and a laparotomy was determined. Meckel’s diverticulum was diagnosed with bleeding. Removal of diverticulum pathology reported Meckel diverticulum, gastric mucosal tissue can be seen. Follow-up 3 years without recurrence.