Chen Chuang-Wei, Hsiao Cheng-Wen, Wu Chang-Chieh, Jao Shu-Wen, Lee Tsai-Yu, Kang Jung-Chen
Division of Colon and Rectal Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
J Emerg Med. 2010 Aug;39(2):178-80. doi: 10.1016/j.jemermed.2007.09.026. Epub 2008 Jan 28.
Acute appendicitis is one of the most common surgical emergencies. Accurate diagnosis is often hindered due to various presentations that differ from the typical signs of appendicitis, especially the position of the appendix. A delay in treatment increases the likelihood of complications such as perforation, which is associated with an increase in morbidity and mortality rates. We herein present the case of a 76-year-old woman presenting with necrotizing fasciitis of the abdominal wall and right flank regions due to a perforated appendix. Such complication is extremely rare but life-threatening. It may be confused with cellulitis, causing a delay in aggressive treatment. This case represents an unusual complication of a common disease. Also, acute appendicitis or intra-abdominal pathologies should be taken into consideration in determining the cause of necrotizing fasciitis presenting over abdominal, flank, or perineal regions.
急性阑尾炎是最常见的外科急症之一。由于各种临床表现与典型的阑尾炎体征不同，尤其是阑尾的位置，准确诊断常常受到阻碍。治疗延迟会增加诸如穿孔等并发症的可能性，而穿孔会导致发病率和死亡率上升。我们在此报告一例76岁女性因阑尾穿孔导致腹壁和右胁腹区域坏死性筋膜炎的病例。这种并发症极为罕见但危及生命。它可能与蜂窝织炎相混淆，导致积极治疗延迟。该病例代表了一种常见疾病的不寻常并发症。此外，在确定腹部、胁腹或会阴区域出现的坏死性筋膜炎的病因时，应考虑急性阑尾炎或腹腔内病变。
