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既往有阑尾切除术的患者出现复发性右下腹疼痛。

Recurrent right iliac fossa pain in patients with previous appendicectomy.

作者信息

Cobb Will, Keeler Barrie, Aris Chandran Johan, Soin Bob

机构信息

Department of General Surgery, Wexham Park Hospital, Slough, Berkshire, UK.

Wexham Park Hospital, Slough, Berkshire, UK.

出版信息

BMJ Case Rep. 2015 May 6;2015:bcr2014207971. doi: 10.1136/bcr-2014-207971.

Abstract

Recurrent appendicitis can occur up to 40 years after appendicectomy. A history of appendicectomy has often led to late diagnosis, as sepsis is attributed to other organs, usually the urinary tract. A case of a patient presenting with retained faecolith and recurrent/stump appendicitis 2 years after laparoscopic appendicectomy is presented. The case for having a low threshold for early CT scanning in patients post-appendicectomy presenting with sepsis to prevent delay in diagnosis is made, and this case is a useful reminder for surgeons to dissect as far as possible to the appendix base. The literature including important medicolegal cases is reviewed.

摘要

复发性阑尾炎可在阑尾切除术后长达40年发生。阑尾切除史常常导致诊断延迟,因为脓毒症被归因于其他器官,通常是泌尿系统。本文报告一例患者,在腹腔镜阑尾切除术后2年出现粪石残留及复发性/阑尾残株炎。本文提出对于阑尾切除术后出现脓毒症的患者应降低早期CT扫描的阈值以防止诊断延迟,该病例提醒外科医生尽可能向阑尾根部进行解剖。本文回顾了包括重要法医学病例在内的文献。

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