Perger Lena, Muensterer Oliver J
Department of Surgery, University of Alabama, Birmingham, AL, USA.
JSLS. 2011 Oct-Dec;15(4):565-7. doi: 10.4293/108680811X13176785204634.
Torsion of an otherwise normal appendix vermiformis is exceedingly rare and usually presents with symptoms consistent with acute appendicitis. We present the unusual case of an infant girl who was admitted with right lower quadrant pain and focal peritonitis who was found to have appendiceal torsion on laparoscopy.
An 11-week-old girl was brought to the emergency department with a 48-hour history of abdominal pain, emesis, low-grade fever, and focal right lower quadrant tenderness. Sonography found a noncompressible distended appendix in the right lower quadrant. Upon laparoscopy, a torsed, necrotic appendix vermiformis was found. Appendectomy was performed, and the patient recovered uneventfully.
In an infant girl with lower abdominal pain, the differential diagnosis should include torsed appendix besides more common causes, such as torsed ovary, intussusception, or small bowel volvulus. Ultrasound is useful for planning the operative approach.
正常阑尾发生扭转极为罕见，通常表现出与急性阑尾炎相符的症状。我们报告一例不寻常的病例，一名女婴因右下腹疼痛和局限性腹膜炎入院，腹腔镜检查发现为阑尾扭转。
一名11周大的女孩因腹痛、呕吐、低热和右下腹局限性压痛48小时被送往急诊科。超声检查发现右下腹有一个不可压缩的扩张阑尾。腹腔镜检查发现扭转、坏死的阑尾。进行了阑尾切除术，患者恢复顺利。
对于患有下腹痛的女婴，鉴别诊断除了更常见的病因，如卵巢扭转、肠套叠或小肠扭转外，还应包括阑尾扭转。超声有助于规划手术入路。
