Cobb Will, Keeler Barrie, Aris Chandran Johan, Soin Bob
Department of General Surgery, Wexham Park Hospital, Slough, Berkshire, UK.
Wexham Park Hospital, Slough, Berkshire, UK.
BMJ Case Rep. 2015 May 6;2015:bcr2014207971. doi: 10.1136/bcr-2014-207971.
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.
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。