Author/Editor		Višnar Perovič, Alenka; Koren, Aleš
Title		Ultrasonographic diagnnosis of obstructive ileus in a patient with Meckel's diverticulum
Translated title		Ultrazvočna diagnostika obstruktivnega ileusa pri bolniku z Meckelovim divertiklom
Type		članek
Source		Radiol Oncol
Vol. and No.		Letnik 33, št. 3
Publication year		1999
Volume		str. 193-8
Language		eng
Abstract		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 still within 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 diagnosis.
Summary		Uvod. 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 diagnozi.
Descriptors		MECKEL'S DIVERTICULUM INTESTINAL OBSTRUCTION ADULT