Meckel的憩室是胃肠道的先天性异常，发生在2-3％的人群中。它通常是无症状的，只有在有并发症时才以特定的方式表现。最常见的并发症是对小肠的阻塞，异位胃溃疡的出血和憩室炎。一种不寻常的并发症是疝气的疝气在疝中的憩室，称为Littre的疝气，代表Meckel的憩室所有并发症的10％。临床上很难区分小肠环的参与，并且在腹股沟疝中的梅克尔的参与，并且很少地制造精确的术前诊断。其中大多数是临床沉默，并且经常在剖腹手术期间或在腹股沟切口中发现。我们提出了一种扼杀的腹股沟疝，含有Meckel的憩室，作为内容，并讨论了无症状/偶然检测分憩的外科手术管理选择。

Meckel的憩室是胃肠道的先天性异常，发生在2-3％的人群中。它通常是无症状的，只有在有并发症时才以特定的方式表现。最常见的并发症是对小肠的阻塞，异位胃溃疡的出血和憩室炎。一种不寻常的并发症是疝气的疝气在疝中的憩室，称为Littre的疝气，代表Meckel的憩室所有并发症的10％。临床上很难区分小肠环的参与，并且在腹股沟疝中的梅克尔的参与，并且很少地制造精确的术前诊断。其中大多数是临床沉默，并且经常在剖腹手术期间或在腹股沟切口中发现。我们提出了一种扼杀的腹股沟疝，含有Meckel的憩室，作为内容，并讨论了无症状/偶然检测分憩的外科手术管理选择。

梅克尔憩室是一种先天性胃肠道异常，发生在2-3%的人口[1]。位于肠系膜反缘的真憩室。它是卵黄肠管或脐肠管的宿存肠部的残体，包括所有肠层。它通常是无症状的，只有在有并发症时才以特定的方式表现。最常见的并发症是小肠梗阻、异位胃溃疡出血、憩室炎[2]。一个不寻常的并发症是梅克尔憩室疝，称为Littre疝，占梅克尔憩室所有并发症的10%[3,4]。尽管有现代的研究工具，它的诊断通常是困难的。在大多数情况下，这只是偶然的发现。我们在此提出一个非常罕见的病例绞窄梅克尔憩室在腹股沟疝(利特尔疝)，只是在手术中变得明显。

一名73岁的男子来到急诊部门，自1天以来，患痛苦的痛苦和肿胀。疼痛是连续的，严重与呕吐有关，递推。他众所周知，持续两年的肿胀是无痛的，很容易减少。患者的体检显示出明显减少的一般情况，发热，具有心动过速，但是正规的。腹部检查显示温和的光泽和夸张的肠声。然而，在局部检查右侧腹股沟延伸到阴囊底部的坚固和柔软的肿块。肿胀是非脉动，不可擦拭的，温暖的。腹部的普通X射线薄膜显示出肠道环，具有多种空气流体水平的暗示性阻塞。他的实验室研究表明血液白细胞数增加。超声波显示囊中的肠道环，失去血管。 The diagnosis of strangulated inguinal hernia was made. The patient was admitted to the operating room after further workup. Surgery was done by inguinal approach. Sac was opened and meckel’s diverticulum was noted which is distended and gangrenous, and a part of ileum was also ischemic. The diverticulum is approximately 8 cm in length which is completely gangrenous. Resection of small bowel with diverticulum was done and end-toend anastomosis was performed. Herniorrhaphy by tissue approximation repair using Bassini’s technique was done and no mesh was placed. The post-operative course was uneventful. Follow up period for 6 months showed no recurrence or further complications.

梅克尔憩室是最常见的先天性小肠异常，估计发病率约为2%[5]。它是一个真正的憩室，包括所有肠层[6,7]。这是正常情况下消失的卵黄肠管持续存在的结果。据报道，梅克尔憩室的并发症发生率为4%[8]。这些并发症包括憩室炎、胃肠道出血、肠梗阻、肠带形成、绞窄、恶性肿瘤。绞窄、穿孔和疝是极其罕见的。1700年，法国外科医生亚历克西斯·利特尔(Alexis Littre)第一个报告了3例嵌顿股疝合并小肠憩室的病例。此后，只有梅克尔憩室的疝囊被称为利特尔疝[9]。利特尔疝是由梅克尔憩室突出通过疝口[10]引起的。发病情况尚不清楚。Littre疝的常见部位为腹股沟(50%)、脐(20%)、股(20%)、切口及其他部位(10%)[11]。 Clinically, it is difficult to distinguish between involvement of a small bowel loop and meckel’s in an inguinal hernia and accurate preoperative diagnosis is seldom made. Most of them are clinically silent and often incidentally found during laparotomy or in an inguinal incision as in our case. Only 4-6% of cases of meckel diverticulum will produce symptoms (more frequent during infancy). Painless gastrointestinal bleeding is more common as an initial presentation in children, occurring in 10.9 to 38.9% of cases and the majority of cases are located in umbilical hernias [10]. In adults, painful inflammation (diverticulitis) or bowel obstruction are the more common presentations. Bowel obstruction results from intussusception, inflammation, omphalomesenteric bands, adhesions, or adenocarcinoma, and accounts for 26.2 to 53.4% of complications. Symptomatic meckel’s diverticulum should be removed surgically, in addition, pathologic diverticula found incidentally on laparotomy should also be removed [9]. However, the management of incidentally discovered asymptomatic diverticula is much more controversial. Some feel that they should not be removed or perhaps only removed in younger patients [9]. Some authors advocate resection of diverticula in all patients regardless of age or pathology while others recommend resection of incidentally detected diverticula during surgery. Surgical resection consists of either simple diverticulectomy or bowel resection of the involved small bowel and primary anastomosis depending on the clinical situation [12]. Some surgeons prefer an Ileocecal resection rather than a simple excision given the possibility of ectopic tissue extending beyond the diverticulum. It would be wise to resect the meckel’s diverticulum that was found incidentally during surgery to prevent such complications of bleeding, obstruction, strangulation. On the other hand, incidentally detected Meckel’s diverticulum on imaging may be left alone with a caution of close follow-up.

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