Makama J G, Ahmed A, Ukwenya Y, Mohammed I
Department of Surgery, A B U Teaching Hospital, Shika-Zaria, Nigeria.
Ann Afr Med. 2009 Apr-Jun;8(2):133-5. doi: 10.4103/1596-3519.56243.
A mobile caecum and ascending colon is a rare congenital abnormality. Its presentation as a cause of right lower abdominal pain in an adult is usually mis-diagnosed as acute appendicitis. A 42-year-old civil servant presented with a 2-year history of recurrent right lower quadrant pain of the abdomen. The pain was sharp in nature and persistent in the last 2 weeks and centered mainly in the right side of the abdomen. No other associated symptoms were noted. Laboratory investigations did not reveal obvious abnormality. A diagnosis of acute on chronic lower quadrant pain of unknown etiology was made. The patient was resuscitated and had exploratory laparatomy. No abnormalities were found other than the caecum and the whole ascending colon, which were unattached to the posterior peritoneum. Appendectomy and caecopexy, using a lateral peritoneal flap were performed. The diagnosis of mobile caecal syndrome should be considered in patients with chronic right lower quadrant pain, and appendectomy and caecopexy offers a great relief.
移动盲肠和升结肠是一种罕见的先天性异常。其在成人中表现为右下腹痛的病因通常被误诊为急性阑尾炎。一名42岁的公务员有2年复发性右下腹腹痛病史。疼痛性质尖锐，在过去2周持续存在，主要集中在腹部右侧。未发现其他相关症状。实验室检查未发现明显异常。诊断为病因不明的慢性下腹痛急性发作。患者接受复苏并进行了剖腹探查术。除盲肠和整个升结肠未附着于后腹膜外，未发现其他异常。采用侧腹膜瓣进行了阑尾切除术和盲肠固定术。对于慢性右下腹痛患者应考虑移动盲肠综合征的诊断，阑尾切除术和盲肠固定术可带来极大缓解。
