648 KB17 KB199220251999Koren, AlešVišnar-Perovič, Alenkaštevilka:3letnik:33str. 193-198COBISSID:10779353ISSN:1318-2099URN:URN:NBN:SI:doc-0P8RRUFFenCroatian Medical Association - Croatian Society of RadiologySlovenian Medical Society - Section of RadiologyRadiology and oncology (Ljubljana)AdultComplicationsdiagnostikaileusIntestinal obstructionMeckel's diverticulumprebavilaprebavni trakttrebuhUltrasonographyultrazvočna diagnostikaUltrasonographic diagnnosis of obstructive ileus in a patient with Meckel's diverticulum| Ultrazvočna diagnostika obstruktivnega ileusa pri bolniku z Meckelovim divertiklom|Introduction. Despite the use of modern imaging techniques, the reliable preoperative assessment of Meckel's diverticulurn and related complications with this rare congenital anomaly of the gastrointestinal tract in adults is uncomrnon. Case presentation. This report presents the case of a 25 year old man who presented with a sudden onset of pain in the right lower abdomen and vomiting. On clinical examination the affected area was tender to palpation which revealed an elastic cylindrical formation situated deeply in the abdomen. Blumberg's sign was positive while the laboratory findings were stillwithin normal limits. An ultrasonography of the abdomen revealed an ileocaecal fluid collection containing thicker residue, which was suspicious for Meckel's diverticulum or a duplication cyst and ileus of the small bowel proximally from the formation described. Native radiogram of the abdomen in supine position has confirmed the presence of obstructive ileus at the level of the distal part of the small bowel. Surgery revealed an ileus and compression of the distal part of the small bowel due to the presence of an edematous Meckel's diverticulum. Conclusion. In view of the frequent use of ultrasonography in the evaluation of acute ahdomen, the diagnostic procedures could be rationalized and the time to surgery reduced if possible complicatioris due to Meckel's diverticulum would he considered in the differential diagnosisUvod. Kljub uporabi modernih slikovnih tehnik, zanesljiva preoperativna ocena Meckelovega divertikla in z njim povezanih komplikacij te redke prirojene anomalije prebavnega trakta mnogokrat ni mogoča. Predstavitev. Predstavljmo primer 25 letnega moškega, pri katerem se je pojavila nenadna bolečina v spodnjem abdomnu desno. Klinično je bil predel občutljiv na palpacijo, ki je pokazala elastično, valjasto strukturo globoko v trebuhu. Blumbergov znak je bil pozitiven, laboratorijske vrednosti pa v mejah normale. Ultrazvok abdomna je ileocekalno pokazal tekočinsko kolekcijo z gosto vsebino, sumljivo za Meckelov divertikel ali duplikacijsko cisto in ileus ozkega črevesa proksimalno od opisane strukture. Nativni rentgenogram stoje je potrdil prisotnost obstrukcijskega ileusa v distalnem delu ozkega črevesa. Kirurški poseg je odkril ileus in kompresijo distalnega dela ozkega črevesa zaradi prisotnosti edematoznega Meckelovega divertikla. Zaključek. Glede na pogosto uporabo ultrazvoka pri oceni akutnega abdomna, bi lahko racionalizirali diagnostični postopek in skrajšali čas do kirurške intervencije, če bi možne zaplete Meckelovega divertikla upoštevali v diferencialni diagnoziTEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaOnkološki inštitut Ljubljana