Kumar Devendra, Ramanathan Subramaniyan, Al Faki Ahmad, Nepal Pankaj
Consultant, Department of Clinical Imaging, Hamad Medical Corporation, Doha, Qatar.
Consultant, Department of Clinical Imaging, Hamad Medical Corporation, Doha, Qatar
Trop Doct. 2015 Oct;45(4):241-4. doi: 10.1177/0049475515577749. Epub 2015 Mar 29.
The subhepatic position of an appendix may lead to difficulty in diagnosis of appendicitis, its surgical management as well as bizarre complications. A 'lost' appendicular faecolith is not an uncommon complication due to spillage during the removal of the appendix or due to perforation. Here we report a case of such a faecolith migrating into the liver parenchyma following intraoperative hepatic injury, and producing a liver abscess. The calcified lesion seen in the liver corresponded to a free-lying faecolith on a preoperative computed tomography scan. Liver abscess was presumed to arise from implantation of this foreign object into the liver parenchyma. Pigtail drainage of abscess was performed with good result.
阑尾位于肝下可能导致阑尾炎诊断困难、手术处理棘手以及出现离奇的并发症。“丢失”的阑尾粪石是一种并不罕见的并发症,其成因可能是阑尾切除术中粪石溢出,也可能是阑尾穿孔。在此,我们报告一例粪石在术中肝脏损伤后移入肝实质并导致肝脓肿的病例。肝脏中发现的钙化病灶在术前计算机断层扫描中对应一个游离的粪石。肝脓肿被推测是由于这个异物植入肝实质所致。对脓肿进行了猪尾导管引流,效果良好。