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以腹壁及右腹股沟脓肿为表现的急性阑尾炎:一例报告

Acute appendicitis presenting with abdominal wall and right groin abscess: a case report.

作者信息

Yildiz Mustafa, Karakayali Ahmet-Sevki, Ozer Saadet, Ozer Hilal, Demir Aydin, Kaptanoglu Bugra

机构信息

Department of General Surgery, Ministry of Health Ankara Training and Research Hospital, Ulucanlar, Ankara, Turkey.

出版信息

World J Gastroenterol. 2007 Jul 14;13(26):3631-3. doi: 10.3748/wjg.v13.i26.3631.

Abstract

We report a case of right lower abdominal wall and groin abscess resulting from acute appendicitis. The patient was an 27-year-old man who had no apparent abdominal signs and was brought to the hospital due to progressive painful swelling of right lower abdomen and the groin for 10 d. Significant inflammatory changes of soft tissue involving the right lower trunk were noted without any apparent signs of peritonitis. Laboratory results revealed leukocytosis. Abdominal ultrasonography described the presence of abscess at right inguinal site also communicating with the intraabdominal region. Right inguinal exploration and laparotomy were performed and about 250 mL of pus was drained from the subcutaneous tissue and preperitoneal space. No collection of pus was found intraabdominally and subserous acute appendicitis was the cause of the abscess. The patient fully recovered at the end of the second post-operation week. This case reminds us that acute appendicitis may have an atypical clinical presentation and should be treated carefully on an emergency basis to avoid serious complications.

摘要

我们报告一例因急性阑尾炎导致右下腹壁和腹股沟脓肿的病例。患者为一名27岁男性,无明显腹部体征,因右下腹和腹股沟进行性疼痛肿胀10天入院。注意到右下腹软组织有明显炎症改变,但无任何明显的腹膜炎体征。实验室检查结果显示白细胞增多。腹部超声检查发现右腹股沟部位有脓肿,且与腹腔相通。进行了右腹股沟探查和剖腹手术,从皮下组织和腹膜前间隙引流约250毫升脓液。腹腔内未发现积脓,浆膜下急性阑尾炎是脓肿的病因。患者在术后第二周结束时完全康复。该病例提醒我们,急性阑尾炎可能有非典型临床表现,应在紧急情况下谨慎治疗,以避免严重并发症。

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本文引用的文献

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Appendectomy: a contemporary appraisal.阑尾切除术:当代评估
Ann Surg. 1997 Mar;225(3):252-61. doi: 10.1097/00000658-199703000-00003.
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Thigh abscess. An uncommon presentation of intraabdominal sepsis.
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