Dumitrescu D, Savlovschi C, Borcan R, Pantu H, Serban D, Gradinaru S, Smarandache G, Trotea T, Branescu C, Musat L, Comandasu M, Priboi M, Baldir M, Sandolache B, Oprescu S
Universitatea de Medicină şi Farmacie "Carol Davila", Bucureşti, România.
Chirurgia (Bucur). 2011 Sep-Oct;106(5):657-60.
We present the case of a 58-year old male patient admitted in the surgery section of the University Emergency Hospital of Bucharest and diagnosed with acute abdomen. The minimal clinical-paraclinical investigation (i.e., thorax-pulmonary Xray, biological probes) raises questions as to the differentiated diagnosis and other associated diseases, also suggesting the existence of voluminous diaphragmatic hernia. The CT thorax-abdomen examination confirms the diaphragmatic hernia suspicion, with intra-thorax ascent of the colon up to the anterior C4 level, but does not explain the abdominal suffering; thus we suspected a biliary ileus or acute appendicitis. Medial laparotomy was imperative. Intrasurgically peritonitis was noticed located by gangrenous acute apendicitis, perforated, with coprolite, for which apendictomy and lavage-drainage pf the peritoneal cavity was performed. Post-surgical status: favourable to recovery.
我们介绍了一名58岁男性患者的病例，该患者入住布加勒斯特大学急诊医院外科，被诊断为急腹症。最低限度的临床辅助检查（即胸部-肺部X光、生物探针）对鉴别诊断和其他相关疾病提出了疑问，也提示存在巨大膈疝。胸部-腹部CT检查证实了膈疝的怀疑，结肠升入胸腔至C4椎体前缘水平，但无法解释腹部疼痛；因此我们怀疑是胆石性肠梗阻或急性阑尾炎。必须进行剖腹探查术。术中发现由坏疽性急性阑尾炎穿孔引起的腹膜炎，并伴有粪石，为此进行了阑尾切除术和腹腔灌洗引流术。术后状况：有利于康复。
