Ventham Nicholas, Velchuru Vamsi, Scout Earl, Studley John
Department of General Surgery, James Paget University Hospital, Gorelston, UK.
Ann R Coll Surg Engl. 2010 Mar;92(2):W32-4. doi: 10.1308/147870810X476773.
Omental infarction is a rare cause of acute abdomen in childhood. We describe a case of omental infarction mimicking acute appendicitis occurring in a child with cyclical neutropenia. Neutropenic enterocolitis, a serious cause of the acute abdomen, has been linked with cyclical neutropenia. In neutropenic patients, omental infarction when diagnosed pre-operatively can be managed conservatively with the focus on improving the neutrophil count. If after imaging the diagnosis is in doubt, there should be a low threshold for laparoscopy. The low incidence of omental infarction will continue to mean that it is a diagnosis made at operation for suspected appendicitis. In these cases, the infarcted tissue may be removed by the laparoscopic or open technique.
网膜梗死是儿童急性腹痛的罕见原因。我们描述了一例发生在周期性中性粒细胞减少症患儿身上、酷似急性阑尾炎的网膜梗死病例。中性粒细胞减少性小肠结肠炎是急性腹痛的一个严重病因，与周期性中性粒细胞减少症有关。在中性粒细胞减少的患者中，术前诊断出网膜梗死时可采取保守治疗，重点是提高中性粒细胞计数。如果影像学检查后诊断存疑，腹腔镜检查的阈值应较低。网膜梗死的低发病率将继续意味着它是在疑似阑尾炎手术时做出的诊断。在这些病例中，梗死组织可通过腹腔镜或开放技术切除。
