■在18岁的时候,Meckel憩室和罕见的卵黄肠纤维带引起肠梗阻。临床医生应该对这种异常现象保持警惕,尤其是年轻的腹部,作为肠梗阻的潜在来源。
■在此案例报告中,我们强调了在成人人群中罕见的引起肠梗阻的卵黄管或脐肠管异常。病人,一个18岁的男性,有两天腹痛和呕吐的病史被送到急诊科。体格检查显示他的处女腹部轻度扩张,并伴有全身压痛。腹部X线显示扩张的小肠环,计算机断层扫描显示特征与闭环肠梗阻一致。诊断性腹腔镜检查证实玻璃体肠管残留是小肠梗阻的原因,涉及Meckel憩室和玻璃体肠纤维带的结合。在早期胎儿发育中,卵黄肠管在中肠和卵黄囊之间连通,预期在胎儿生长过程中消失。无法消除可能导致肠道阻塞等问题,主要在儿童身上观察到,发生在成年人身上,在这种情况下,很少发生,只有几个记录的实例。尽管它在年轻人中不常见,医疗保健提供者应将卵黄肠管异常残留视为肠梗阻的潜在来源,尤其是腹部处女的个体。早期发现肠梗阻对患者生存至关重要,促进及时管理,最大限度地减少严重疾病的风险,最终有助于更好的患者结果。
UNASSIGNED: In an 18-year-old, Meckel\'s diverticulum and a rare vitellointestinal fibrous band caused bowel obstruction. Clinicians should be vigilant for such anomalies, especially in young adults with virgin abdomens, as potential sources of intestinal obstruction.
UNASSIGNED: In this case report, we highlight the rarity of vitellointestinal or omphalomesenteric duct anomalies causing intestinal obstruction in the adult population. The patient, an 18-year-old male, presented to the emergency department with a two-day history of abdominal pain and vomiting. Physical examination revealed mild distension of his virgin abdomen with generalized tenderness. Abdominal X-ray displayed dilated small bowel loops, and a computed tomography scan indicated features consistent with closed-loop bowel obstruction. Diagnostic laparoscopy confirmed a vitellointestinal duct remnant as the cause of the small intestinal obstruction, involving a combined Meckel\'s diverticulum and vitellointestinal fibrous band. In early fetal development, the vitellointestinal duct communicates between the midgut and the yolk sac, expected to disappear during fetal growth. Failure to obliterate can lead to issues such as intestinal blockage, primarily observed in children, making occurrences in adults, as in this case, infrequent with only a few documented instances. Despite its uncommon occurrence in young adults, healthcare providers should consider the vitellointestinal duct anomalous remnant as a potential source of intestinal obstruction, particularly in individuals with a virgin abdomen. Early detection of intestinal obstruction is imperative for patient survival, facilitating prompt management and minimizing the risk of serious morbidities, ultimately contributing to a better patient outcome.