Domingues-Ferreira Maurício, Saddi-Rosa Pedro, Dos Santos André Luis
Hospital da Policia Militar, 04021-001 São Paulo, SP, Brazil.
Case Rep Med. 2011;2011:467137. doi: 10.1155/2011/467137. Epub 2011 Mar 16.
The general consensus is that appendicitis is basically provoked by fecaliths or lymphoid hyperplasic obstruction. Several studies based on histological diagnosis have not confirmed this hypothesis. On the contrary, obstruction has been proved in only a minority of cases. Diverse infections by parasites, bacteria, fungus, and noninfective agents have been associated with appendicitis in the medical literature. We describe a firefighter, who ingested a small quantity of leachate from decomposing corpses while working and developed enteritis a few hours later, which lasted several days and evolved to appendicitis. This case raises the possibility that the high quantity of bacteria concentration present in the leachate could have provoked enteritis and the subsequent appendicitis due to a direct effect of the bacteria on the appendix.
普遍的共识是阑尾炎基本上是由粪石或淋巴组织增生性梗阻引发的。几项基于组织学诊断的研究并未证实这一假说。相反，仅在少数病例中证实存在梗阻。医学文献中已将寄生虫、细菌、真菌和非感染性因素的多种感染与阑尾炎相关联。我们描述了一名消防员，他在工作时摄入了少量来自腐烂尸体的渗滤液，几小时后患上肠炎，持续了数天并发展为阑尾炎。该病例增加了一种可能性，即渗滤液中高浓度的细菌可能由于细菌对阑尾的直接作用而引发肠炎及随后的阑尾炎。
