新生児メッケル憩室穿孔の一治験例ならびに本邦報告例の検討

概要

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The patient was delivered by cesarean section at 33 weeks of gestation, because of rupture of the amniotic sac in 18th week and subsequent sepsis. He was born as a triplet with the birth weight of l,500g. Apgar score immediately after the delivery was eight. Abdominal distention and billious vomiting started from the first day of life and scout film of the abdomen showed a large air bubble in the right side. Distention of the abdomen increased and patient's condition deteriorated on the third day of life and pneumoperitoneum was found. Emergency laparotomy disclosed peritonitis with perforated cystic Meckel's diverticulum (7 cm in diameter) located at 5cm from ileocecal valve. The diverticulum was removed and found to contain no ectopic tissue whatsoever. Dilated portion of the diverticulum was lined by one layer of cuboidal epithelial cells. Proper muscle layer around the perforation was absent. Marked congestion, hemorrhage and infiltration of the inflammatory cells were found in the submucosal as well as subserosal layers. The patient's postoperative course was uneventful except transient hyper bilirubinemia. Fourteen cases of perforated Meckel's diverticulum in newborn infants were summerized from Japanene literature and circulatory disturbance in the wall of the diverticulum by ballooning and / or torsion of the neck of diverticulum was suggested as a pathogenesis of the perforation in newborn period.
日本小児外科学会の論文
1984-08-20