Third Intensive Care Department Evgenidion Hospital, Athens, Greece.
Third Intensive Care Department Evgenidion Hospital, Athens, Greece.
Am J Med Sci. 2012 Feb;343(2):168-170. doi: 10.1097/MAJ.0b013e3182318590.
A case of fasciitis and septic shock complicating retrocecal appendicitis is presented.
A 52-year-old man presented to the Emergency Department with lumbar pain, fever of recent onset and subsequently developed septic shock attributed to fasciitis of abdominal, flank and groin region. On intensive care unit, he was managed with broad-spectrum intravenous antibiotics and surgical debridement. An abdominal computed tomography scan confirmed the findings of fasciitis and was negative for intra-abdominal pathology. In the following days, an enterocutaneous fistula with foul smelling fluid was noted. A new surgical exploration revealed the presence of a ruptured retrocecal appendix, and right hemicolectomy was performed. The postoperative period was long but uneventful.
Retrocecal appendicitis can rarely be presented as deteriorating cellulitis-fasciitis in the right abdominal, flank or groin region, with or without abdominal symptoms.
本文报告了一例并发筋膜炎和感染性休克的回盲后阑尾炎病例。
一名 52 岁男性因腰痛、近期发热就诊于急诊科，随后出现了归因于腹部、侧腹和腹股沟区域筋膜炎的感染性休克。在重症监护病房，他接受了广谱静脉内抗生素和外科清创术治疗。腹部 CT 扫描证实了筋膜炎的发现，且无腹腔内病变。在接下来的几天里，出现了带有恶臭液体的肠皮瘘。新的外科探查显示回盲后阑尾破裂，行右半结肠切除术。术后恢复时间长，但无并发症。
回盲后阑尾炎罕见地以右侧腹部、侧腹或腹股沟区域进行性蜂窝织炎-筋膜炎的形式出现，伴有或不伴有腹部症状。
