抄録
メッケル憩室は^<99m>Tc-pertechnetateシンチで,病変に集積すると言われているが,診断に苦慮することも多い.今回繰り返す腸閉塞に対し,腹腔鏡下に腹腔内検索を行い,本症による憩室炎および癒着性腸閉塞と診断し得た症例を経験したので報告する.患児は12歳,女児.6歳,7歳,10歳時に原因不明の腸閉塞を繰り返していた.原因精査の為当科に紹介され,検索をすすめたが原因を特定できなかった.繰り返す腸閉塞に対し,鏡視下に腹腔内を検索したところ,回腸に本症を認め,周囲に癒着を伴っていた.鏡視下に癒着を剥離し憩室切除術を施行した.本症は,待機的に手術を施行できることが多く,鏡視下手術のよい適応であるが術前に診断し得ない症例がある.小児で原因不明の腸閉塞を見たときは,本症の可能性を考慮し診断を目的とした鏡視下手術を施行することは有用である.
Though ^<99m>Tc-pertechnetate scan is useful for a diagnosis of Meckel's diverticulum, it is often difficult to make the diagnosis. We report a case of successful diagnosis and treatment for recurrent ileus of Meckel's diverticulum by laparoscopic procedure. The patient was a 12-year-old girl with a past history of uncertain ileus at the age of 6, 7, and 10. Some examinations including ^<99>mTc-pertechnetate scans could not show the case of ileus. The laparoscope revealed that the ileus was due to adhesion around a Meckel's diverticulum. Then she was underwent GI laparoscopic adhesiotomy and diverticulectomy. Meckel's diverticulum is a good indication of laparoscopic surgery because elective surgery is possible in most patients. However, there is difficulty in making the diagnosis of Meckel's diverticulum before surgery. Laparoscopic surgery is useful in the treatment of ileus due to unknown cause.
