梅克尔憩室并出血的血管造影诊断(附6例报告)

Angiographic findings of Meckel's diverticulum with bleeding (reports of 6 cases)

目的:认识梅克尔憩室出血的血管造影表现,提高对胃肠道出血的血管造影诊断的阳性率。方法:回顾性分析6例梅克尔憩室伴出血的血管造影表现特点。男5例,女1例,以Seldinger技术插管行选择性肠系膜上动脉造影,显示病变后,带管急诊手术治疗,并做病理检查。结果:血管造影表现有:①对比剂外溢2例,对比剂直接外溢出血管至憩室内,显示出袋状憩室影像。②憩室染色2例。表现毛细血管期回盲部区域一局限性条状或片状浓密染色区。③肠卵黄动脉显影3例,显示一细长无分支血管（通常是肠系膜上动脉的回肠支即卵黄动脉）直达右下腹至显影之憩室。手术所见憩室内有出血点及炎性表现。结论:憩室染色和肠卵黄动脉显示梅克尔憩室的主要血管造影表现;对比剂外溢至憩室内是梅克尔憩室伴出血的典型血管造影表现。

Objective:To improve the knowledge of angiographic findings of Meckel s diverticulum with bleeding and the angiographic diagnosis of gastrointestinal bleeding. Methods: Angiographic findings of Meckel s diverticulum with bleeding were retrospectively analyzed in 6 patients. Results; Angiographic findings were as follows: (1)extravasation of contrast material into diverticulum in 2 cases ;(2)diverticular mucosa staining in ileum and cecum region in 2 cases; (3) visualization of anomalous vitelline artery in 3 cases, which appeared as a fine long nonbranching artery that coursed toward the right lower quadrant to display the diverticulum. Conclusion: The diverticular mucosa staining and visualization of anomalous vitelline artery are the main angiographic findings of Meckel s diverticulum with bleeding. Extravasation of contrast material into diverticular lumen,however,is the typical angiographic characteristic.