Taslakian Bedros, Issa Ghada, Hourani Roula, Akel Samir
Department of Diagnostic Radiology, American University of Beirut Medical Center, Beirut, Lebanon.
BMJ Case Rep. 2013 Jun 10;2013:bcr2013009474. doi: 10.1136/bcr-2013-009474.
Acute appendicitis is one of the most common conditions requiring emergency surgery. However, acute appendicitis presenting with left lower quadrant abdominal pain is extremely rare. Imaging, particularly CT , plays an important role in establishing an accurate and prompt diagnosis, as delay in diagnosis may occur due to lack of uniformity in the clinical signs and symptoms. We report a rare case of a 10-year-old boy who presented with persistent left lower quadrant pain of several days duration, in which the CT scan of the abdomen and pelvis was essential in establishing the correct diagnosis. The malpositioned inflamed appendix was clearly identified in the left side of the abdomen, with the characteristic CT findings of uncomplicated intestinal malrotation. Left-sided acute appendicitis should be considered in the differential diagnosis of young patients presenting with left lower quadrant pain, in order to avoid delay in diagnosis and guide the surgical intervention.
急性阑尾炎是最常见的需要急诊手术的病症之一。然而，以左下腹疼痛为表现的急性阑尾炎极为罕见。影像学检查，尤其是CT，在准确、及时地做出诊断方面起着重要作用，因为临床体征和症状缺乏一致性可能导致诊断延迟。我们报告一例罕见病例，一名10岁男孩持续左下腹疼痛数天，腹部和盆腔CT扫描对于明确正确诊断至关重要。在腹部左侧清晰地识别出位置异常的发炎阑尾，具有单纯性肠旋转不良的典型CT表现。对于出现左下腹疼痛的年轻患者，鉴别诊断时应考虑左侧急性阑尾炎，以避免诊断延迟并指导手术干预。
