儿童梅克尔憩室并发症:临床特征与治疗
Complications of Meckel’s Diverticulum in Children: Clinical Features and Treatment
DOI: 10.12677/acm.2025.1541027, PDF,   
作者: 陈天琰, 康 权*:重庆医科大学附属儿童医院普外创伤外科,国家儿童健康与疾病临床医学研究中心,儿童发育疾病研究教育部重点实验室,重庆;儿童发育重大疾病国家国际科技合作基地,重庆;结构性出生缺陷与器官修复重建重庆市重点实验室,重庆
关键词: 梅克尔憩室并发症儿童治疗Meckel’s Diverticulum Complications Children Treatment
摘要: 梅克尔憩室(MD)是一种常见的消化道畸形,可能出现消化道出血、肠梗阻、憩室炎、肠穿孔或合并肿瘤等并发症。由于其症状缺乏特异性,临床检查也缺乏明确的特异性指标,同时医师对MD的认识不足,导致误诊和漏诊的情况较为普遍。本综述通过总结MD的并发症及其诊疗情况,旨在提高临床医生对MD及其并发症的认识,实现早期诊断与治疗,改善患儿的预后,并为临床医生在MD的诊断与治疗实践中提供理论依据和参考建议。
Abstract: Meckel’s diverticulum (MD) is a common gastrointestinal malformation that may present with complications such as gastrointestinal bleeding, intestinal obstruction, diverticulitis, intestinal perforation, or the presence of tumors. Due to the nonspecific nature of its symptoms and the lack of definitive diagnostic indicators in clinical examinations, coupled with insufficient awareness of MD among physicians, misdiagnosis and missed diagnosis are relatively common. This review aims to summarize the complications and diagnostic and therapeutic approaches of MD. It seeks to enhance clinicians’ understanding of MD and its complications, facilitate early diagnosis and treatment, improve the prognosis of pediatric patients, and provide theoretical basis and reference suggestions for clinicians in the diagnosis and treatment of MD.
文章引用:陈天琰, 康权. 儿童梅克尔憩室并发症:临床特征与治疗[J]. 临床医学进展, 2025, 15(4): 1046-1052. https://doi.org/10.12677/acm.2025.1541027

参考文献

[1] Hansen, C. and Søreide, K. (2018) Systematic Review of Epidemiology, Presentation, and Management of Meckel’s Diverticulum in the 21st Century. Medicine, 97, e12154. [Google Scholar] [CrossRef] [PubMed]
[2] Ivatury, R.R. (2019) Meckel’s Diverticulum and the Eponymous Legend. Journal of Trauma and Acute Care Surgery, 87, 451-455. [Google Scholar] [CrossRef] [PubMed]
[3] Morris, G., Kennedy, A. and Cochran, W. (2016) Small Bowel Congenital Anomalies: A Review and Update. Current Gastroenterology Reports, 18, Article No. 16. [Google Scholar] [CrossRef] [PubMed]
[4] Burjonrappa, S. and Khaing, P. (2014) Meckel’s Diverticulum and Ectopic Epithelium: Evaluation of a Complex Relationship. Journal of Indian Association of Pediatric Surgeons, 19, 85-89. [Google Scholar] [CrossRef] [PubMed]
[5] Urrutia Soto, H., Donoso Carrasco, C. and Carvajal Flores, O. (2021) Symptomatic Meckel’s Diverticulum in Pediatrics. Andes Pediatrica, 92, 104-109. [Google Scholar] [CrossRef] [PubMed]
[6] Nissen, M., Sander, V., Rogge, P., Alrefai, M. and Tröbs, R. (2022) Meckel’s Diverticulum in Children: A Monocentric Experience and Mini-Review of Literature. Children, 9, Article No. 35. [Google Scholar] [CrossRef] [PubMed]
[7] He, T., Yang, C., Wang, J., Zhong, J., Li, A., Yin, Y., et al. (2024) Single-center Retrospective Study of the Diagnostic Value of Double-Balloon Enteroscopy in Meckel’s Diverticulum with Bleeding. World Journal of Gastrointestinal Surgery, 16, 1043-1054. [Google Scholar] [CrossRef] [PubMed]
[8] 江楠, 熊冬兰, 张茜. 小儿梅克尔憩室的临床特征及超声表现分析[J].  江西医药, 2019, 54(5): 566-567.
[9] 陈颖, 唐永华, 陈双庆, 等. 72例麦克尔憩室的术前诊断分析[J]. 中华诊断学电子杂志, 2020, 8(4): 258-264.
[10] Baltes, P., Dray, X., Riccioni, M.E., Pérez-Cuadrado-Robles, E., Fedorov, E., Wiedbrauck, F., et al. (2023) Small-Bowel Capsule Endoscopy in Patients with Meckel’s Diverticulum: Clinical Features, Diagnostic Workup, and Findings. a European Multicenter I-CARE Study. Gastrointestinal Endoscopy, 97, 917-926.e3. [Google Scholar] [CrossRef] [PubMed]
[11] Jaramillo, C., Jensen, M.K., McClain, A., Stoddard, G., Barnhart, D. and Ermarth, A.K. (2021) Clinical Diagnostic Predictive Score for Meckel Diverticulum. Journal of Pediatric Surgery, 56, 1673-1677. [Google Scholar] [CrossRef] [PubMed]
[12] Zhao, L., Feng, S., Wu, P., Lai, X., Lv, C. and Chen, G. (2019) Clinical Characteristics and Surgical Outcome in Children with Intussusceptions Secondary to Pathologic Lead Points: Retrospective Study in a Single Institution. Pediatric Surgery International, 35, 807-811. [Google Scholar] [CrossRef] [PubMed]
[13] Zhang, X., Ping, H., Zhang, J., Li, K., Li, D., Chen, K., et al. (2023) Intestinal Obstruction Caused by Mesodiverticular Band in Children: A Cohort Study. Pediatric Surgery International, 39, Article No. 163. [Google Scholar] [CrossRef] [PubMed]
[14] Schizas, D., Katsaros, I., Tsapralis, D., Moris, D., Michalinos, A., Tsilimigras, D.I., et al. (2018) Littre’s Hernia: A Systematic Review of the Literature. Hernia, 23, 125-130. [Google Scholar] [CrossRef] [PubMed]
[15] Schaedlich, D.S., Borges, P.C.d.M., Lacombe, A. and Moron, R.A. (2023) Intestinal Intussusception of Meckel’s Diverticulum, a Case Report and Literature Review of the Last Five Years. Einstein (São Paulo), 21, eRC0173. [Google Scholar] [CrossRef] [PubMed]
[16] Yan, L., Zhou, B., Wu, P., Tian, Y. and Lou, Y. (2024) Meckel’s Diverticulum Mimicking Acute Appendicitis in Children: A Retrospective Cohort Study. BMC Surgery, 24, Article No. 40. [Google Scholar] [CrossRef] [PubMed]
[17] Moreno-Alfonso, J.C., Hernández Martín, S., Molina Caballero, A., Pérez Martínez, A. and Yárnoz Irazábal, M.C. (2024) The “Rule of Two” in Meckel’s Diverticulum: Does It Truly Apply to the Pediatric Population in Our Area? Revista Española de Enfermedades Digestivas. [Google Scholar] [CrossRef] [PubMed]
[18] Dogeas, E., Magallanes, M., Porembka, M.R., Wang, S.C., Yopp, A.C., Polanco, P.M., et al. (2019) Neuroendocrine Tumors in Meckel’s Diverticulum: Recommendation for Lymphadenectomy Regardless of Tumor Size Based on the NCDB Experience. Journal of Gastrointestinal Surgery, 23, 679-685. [Google Scholar] [CrossRef] [PubMed]
[19] Park, J.J., Wolff, B.G., Tollefson, M.K., Walsh, E.E. and Larson, D.R. (2005) Meckel Diverticulum: The Mayo Clinic Experience with 1476 Patients (1950-2002). Annals of Surgery, 241, 529-533. [Google Scholar] [CrossRef] [PubMed]
[20] Zani, A., Eaton, S., Rees, C.M. and Pierro, A. (2008) Incidentally Detected Meckel Diverticulum: To Resect or Not to Resect? Annals of Surgery, 247, 276-281. [Google Scholar] [CrossRef] [PubMed]
[21] Lindeman, R. and Søreide, K. (2020) The Many Faces of Meckel’s Diverticulum: Update on Management in Incidental and Symptomatic Patients. Current Gastroenterology Reports, 22, Article No. 3. [Google Scholar] [CrossRef] [PubMed]
[22] Yagnik, V., Garg, P. and Dawka, S. (2024) Should an Incidental Meckel Diverticulum Be Resected? A Systematic Review. Clinical and Experimental Gastroenterology, 17, 147-155. [Google Scholar] [CrossRef] [PubMed]
[23] Tauro, L., George, C., Rao, B., Martis, J., Menezes, L. and Shenoy, H. (2010) Asymptomatic Meckel’s Diverticulum in Adults: Is Diverticulectomy Indicated? Saudi Journal of Gastroenterology, 16, 198-202. [Google Scholar] [CrossRef] [PubMed]
[24] Zulfikaroglu, B., Ozalp, N., Zulfikaroglu, E., et al. (2008) Is Incidental Meckel’s Diverticulum Resected Safely? The New Zealand Medical Journal, 121, 39-44.
[25] Żyluk, A. (2019) Management of Incidentally Discovered Unaffected Meckel’s Diverticulum—A Review. Polski Przeglad Chirurgiczny, 91, 41-46.
[26] St-Vil, D., Brandt, M.L., Panic, S., Bensoussan, A. and Blanchard, H. (1991) Meckel’s Diverticulum in Children: A 20-Year Review. Journal of Pediatric Surgery, 26, 1289-1292. [Google Scholar] [CrossRef] [PubMed]
[27] Varcoe, R.L., Wong, S.W., Taylor, C.F. and Newstead, G.L. (2004) Diverticulectomy Is Inadequate Treatment for Short Meckel’s Diverticulum with Heterotopic Mucosa. ANZ Journal of Surgery, 74, 869-872. [Google Scholar] [CrossRef] [PubMed]
[28] Lohsiriwat, V., Sirivech, T., Laohapensang, M., et al. (2014) Comparative Study on the Characteristics of Meckel’s Diverticulum Removal from Asymptomatic and Symptomatic Patients: 18-Year Experience from Thailand’s Largest University Hospital. The Journal of the Medical Association of Thailand, 97, 506-512.
[29] Önen, A., Çiğdem, M.K., Öztürk, H., Otçu, S. and Dokucu, A.İ. (2003) When to Resect and When Not to Resect an Asymptomatic Meckel’s Diverticulum: An Ongoing Challenge. Pediatric Surgery International, 19, 57-61. [Google Scholar] [CrossRef] [PubMed]
[30] Redman, E.P., Mishra, P.R. and Stringer, M.D. (2020) Laparoscopic Diverticulectomy or Laparoscopic-Assisted Resection of Symptomatic Meckel Diverticulum in Children? A Systematic Review. Pediatric Surgery International, 36, 869-874. [Google Scholar] [CrossRef] [PubMed]
[31] 周诗琼, 段栩飞, 叶国刚. 小儿Meckel憩室腹腔镜下分型与术式选择的研究[J]. 中国内镜杂志, 2014, 20(7): 673-677.
[32] Skertich, N.J., Ingram, M., Grunvald, M.W., Williams, M.D., Ritz, E., Shah, A.N., et al. (2021) Outcomes of Laparoscopic versus Open Resection of Meckel’s Diverticulum. Journal of Surgical Research, 264, 362-367. [Google Scholar] [CrossRef] [PubMed]
[33] Ezekian, B., Leraas, H.J., Englum, B.R., Gilmore, B.F., Reed, C., Fitzgerald, T.N., et al. (2019) Outcomes of Laparoscopic Resection of Meckel’s Diverticulum Are Equivalent to Open Laparotomy. Journal of Pediatric Surgery, 54, 507-510. [Google Scholar] [CrossRef] [PubMed]
[34] Can, M., Ergin, M., Okur, Ö., Payza, A.D., Polatdemir, K. and Oral, A. (2024) Can Deciphering the Growth of Meckel’s Diverticulum Help Us to Decide the Resection Technique? Frontiers in Surgery, 11, Article ID: 1421732. [Google Scholar] [CrossRef] [PubMed]