Meckel憩室に起因した成人絞扼性イレウスの1例

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  • AN ADULT CASE OF STRANGULATION ILEUS DUE TO MECKEL'S DIVERTICULUM

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Meckel's diverticulum is a congenital anatomy of the digestive tract occuring in 1-2% of all autopsied cases but cases with symptoms only in 8-22%. The disease occurs mostly in children (80-90%) and rarely in adults. We have recently encountered an adult case of strangulation ileus due to Meckel's diverticulum. The case was a 50-year-old man. The patient was admitted to the hospital because of symptoms of ileus. On admission, poeritoneal irritation was absent and diagnostic imaging showed distention of the small intestine alone and no ascites retention. Conservative treatment resulted in the appearance of peritoneal irritation on the following day and, therefore, emergency laparotomy was performed. Laparotomy revealed that the intential tract about 50cm orally from the end of the ileum formed a loop which was twisted and necrotized due to strangulation by Meckel's diverticulum. There was no cord in the diver-ticulum and it was considered that the inflammed diverticulum had adhered to the mesenterium and the neck of the extended diverticulum stranged the base of the ileal loop. The postoperative course was uneventful and the patient was discharged on day 30 after the operation. Among 230 cases operated on for ileus in this hospital since 1980, this was the only adult case of ileus due to Meckel's diverticulum.

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