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右侧憩室炎酷似阑尾炎。

Right-sided diverticulitis mimics appendicitis.

作者信息

Gilmore Thomas, Jordan Charlton, Edelstein Elisabeth

机构信息

Department of Emergency Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania 19107, USA.

出版信息

J Emerg Med. 2013 Jan;44(1):e29-32. doi: 10.1016/j.jemermed.2011.06.035. Epub 2011 Oct 11.

Abstract

BACKGROUND

Right-sided diverticulitis is a rare source of right lower quadrant pain in Western society; however, it is quite common in Asian societies. Right-sided diverticulitis presents very similarly to appendicitis, with right lower quadrant pain, fever, nausea, and laboratory abnormalities, and is often seen in young patients.

OBJECTIVES

In this report, we present a case of right-sided diverticulitis. We review right-sided diverticulitis' diagnosis and management. It is important to diagnose right-sided diverticulitis because it is a good mimic of appendicitis and ideally should be diagnosed before a patient has unnecessary surgery.

CASE REPORT

A 26-year-old Asian woman presented for evaluation of right lower quadrant pain and fever. She was initially thought to have appendicitis clinically, but had right-sided diverticulitis diagnosed by computed tomography (CT) scan. She was admitted and received intravenous antibiotics and bowel rest. Her right-sided diverticulitis resolved in 3 days.

CONCLUSIONS

Severe right lower quadrant pain in young patients of Asian descent can be right-sided diverticulitis. Right-sided diverticulitis is a benign condition managed medically that mimics appendicitis. CT imaging seems to be the best way to avoid unnecessary surgery.

摘要

背景

在西方社会,右侧憩室炎是右下象限疼痛的罕见病因;然而,在亚洲社会却相当常见。右侧憩室炎的表现与阑尾炎非常相似,有右下象限疼痛、发热、恶心及实验室检查异常,且常见于年轻患者。

目的

在本报告中,我们呈现一例右侧憩室炎病例。我们回顾右侧憩室炎的诊断与治疗。诊断右侧憩室炎很重要,因为它极易被误诊为阑尾炎,理想情况下应在患者接受不必要的手术前确诊。

病例报告

一名26岁的亚洲女性因右下象限疼痛和发热前来就诊。临床初步诊断为阑尾炎,但经计算机断层扫描(CT)确诊为右侧憩室炎。她入院接受了静脉抗生素治疗及肠道休息。其右侧憩室炎在3天内痊愈。

结论

亚洲裔年轻患者出现严重右下象限疼痛可能是右侧憩室炎。右侧憩室炎是一种可通过药物治疗的良性疾病,易被误诊为阑尾炎。CT成像似乎是避免不必要手术的最佳方法。

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