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| 1 | Laparoscopic approach to Meckel's diverticulum显示文摘AIM: To retrospective review the laparoscopic management of Meckel Diverticulum(MD) in two Italian Pediatric Surgery Centers.METHODS: Between January 2002 and December 2012, 19 trans-umbilical laparoscopic-assisted(TULA) procedures were performed for suspected MD. The children were hospitalized for gastrointestinal bleeding and/or recurrent abdominal pain. Median age at diagnosis was 5.4 years(range 6 mo-15 years). The study included 15 boys and 4 girls. All patients underwent clinical examination, routine laboratory tests, abdominal ultrasound and technetium-99m pertechnetate scan, and patients with bleeding underwent gastrointestinal endoscopy. The abdominal exploration was performed with a 10 mm operative laparoscope. Pneumoperitoneum was establishedbased on the body weight. Systematic overview of the peritoneal cavity allowed the ileum to be grasped with an atraumatic instrument. The complete exploration and surgical treatment of MD were performed extracorporeally, after intestinal exteriorization through the umbilicus. All patients' demographics, main clinical features, diagnostic investigations, operative time, histopathology reports, conversion rate, hospital stay and complications were registered and analyzed.RESULTS: MD was identified in 17 patients, while 1 had an ileal duplication and 1 a jejunal hemangioma. Fifteen patients had painless intestinal bleeding, while 4 had recurrent abdominal pain and exhibited cyst like structures in an ultrasound study. Eleven patients had a positive technetium-99m pertechnetate scan. In the patients with bleeding, gastrointestinal endoscopy did not name the source of hemorrhage. All patients were subjected to a TULA surgical procedure. An intestinal resection/anastomosis was performed in 14 patients, while 4 had a wedge resection of the diverticulum and 1 underwent stapling diverticulectomy. All surgical procedures were performed without conversion to open laparotomy. Mean operative time was 75 min(range 40-115 min). No major surgical complications were recorded. The median hospital stay was 5-7 d(range 4-13 d). All patients are asymptomatic at a median follow up of 4, 5 years(range 10 mo-10 years).CONCLUSION: Trans-umbilical laparoscopic-assisted Meckel's diverticulectomy is safe and effective in the treatment of MD, with excellent results. | Alfonso Papparella Fabiano Nino Carmine Noviello Antonio Marte Pio Parmeggiani Ascanio Martino Giovanni Cobellis | 2014 | World Journal of Gastroenterology2014，20，25： | 7 |
| 2 | 气囊辅助小肠镜和胶囊内镜对Meckel憩室诊断价值分析显示文摘小肠Meckel憩室可发生反复的消化道出血,严重威胁患者的生命健康。该病临床虽非罕见,但因无特殊临床表现,且传统检查方法如消化道钡剂造影、腹部CT、动脉血管造影等对其检出率均较低,故不易确诊。近年来,随着气囊辅助式小肠镜(BAE)和胶囊内镜(CE)的发展,小肠疾病的检出率有了很大的提高。本研究的目的在于分析BAE和CE对于Meckel憩室疾病的临床诊断价值。 | 俎站飞 麻琬如 宁守斌 毛高平 唐杰 朱鸣 金晓维 | 2015 | 中华消化内镜杂志2015，32，1： | 7 |
| 3 | 小肠憩室误诊为Crohn病原因分析显示文摘目的加强对小肠憩室临床特点的认识,减少临床误诊。方法回顾性分析1例小肠憩室误诊Crohn病的临床资料。结果本例因腹痛10个月,加重伴贫血1月余入院,外院多次误诊为肠梗阻、肠炎,予相应治疗无好转。以腹痛及贫血原因待查收入我院,完善相关检查、排除其他病因后诊断为Crohn病,予美沙拉秦肠溶片治疗好转出院,此后因心慌、气短、腹胀、腹痛多次入院,以小肠炎症性相关疾病长期服用美沙拉秦肠溶片及对症治疗,病情反复,后经剖腹探查、术后病理证实为小肠憩室,行手术治疗,切口愈合后出院。随访2年,未再出现腹痛,贫血纠正。结论临床医生应加强对小肠憩室的认识,当临床遇及原因不明反复出现的腹痛、贫血、肠梗阻表现者且治疗效果欠佳时,应当想到此病的可能;双气囊小肠内镜检查有助于小肠憩室的诊断。 | 张翠芳 王会影 张瑞星 | 2014 | 临床误诊误治2014，27，10： | 3 |
| 4 | Inverted Meckel's diverticulum preoperatively diagnosed using double-balloon enteroscopy显示文摘An inverted Meckel's diverticulum is a rare gastrointestinal congenital anomaly that is difficult to diagnose prior to surgery and presents with anemia, abdominal pain, or intussusception. Here, we report the case of 57-year-old men with an inverted Meckel's diverticulum, who was preoperatively diagnosed using doubleballoon enteroscopy. He had repeatedly experienced epigastric pain for 2 mo. Ultrasonography and computed tomography showed intestinal wall thickening in the pelvis. Double-balloon enteroscopy via the anal route was performed for further examination, which demonstrated an approximately 8-cm, sausage-shaped, submucosal tumor located approximately 80 cm proximal to the ileocecal valve. A small depressed erosion was observed at the tip of this lesion. Forceps biopsy revealed heterotopic gastric mucosa. Thus, the patient was diagnosed with an inverted Meckel's diverticulum, and single-incision laparoscopic surgery was performed. This case suggests that an inverted Meckel's diverticulum should be considered as a differential diagnosis for a submucosal tumor in the ileum. Balloon-assisted enteroscopy with forceps biopsy facilitate a precise diagnosis of this condition. | Kosuke Takagaki Satoshi Osawa Tatsuhiro Ito Moriya Iwaizumi Yasushi Hamaya Hiroe Tsukui Takahisa Furuta Hidetoshi Wada Satoshi Baba Ken Sugimoto | 2016 | World Journal of Gastroenterology2016，22，17： | 2 |
| 5 | 腔内型回肠憩室致肠套叠消化道出血一例显示文摘患者男,33岁,因便血5d入院,既往无特殊病史,入院查体:生命体征术未见异常,腹部平坦,全腹软,未触及压痛及包块,肝脾肋下未触及,肠鸣音6次/min。 | 王凤磊 张福文 李巍 张长淮 姚成礼 | 2017 | 中华消化内镜杂志2017，34，9： | 2 |
| 6 | 不明原因下消化道出血一例显示文摘患者,男,32岁,因“间断便血20年”于2016年4月21日入院。患者20年前无诱因出现便血,约3~4年发作一次,每次排暗红色血便约2 000~3 000ml,伴头晕、心悸、乏力,无意识障碍,无明显腹痛等腹部不适,排便后偶有腹部绞痛。上述症状给予止血药物等对症治疗后可缓解。曾于外院行胃镜、结肠镜及小肠镜检查均未见异常。3年前于我院行消化道血管造影未见异常。现患者因上述症状反复发作就诊于我科。既往无高血压、冠心病及恶性肿瘤病史。入院体格检查:神志清楚,营养中等,皮肤巩膜无黄染,睑结膜无苍白。心、肺听诊无异常。 | 邴浩 李异玲 | 2018 | 临床内科杂志2018，35，12： | 1 |
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