Hendahewa Rasika, Shekhar Ashvini, Ratnayake Sujith
Caboolture Hospital, McKean Street, 4510 Caboolture, QLD, Australia.
Caboolture Hospital, McKean Street, 4510 Caboolture, QLD, Australia.
Int J Surg Case Rep. 2015;14:101-3. doi: 10.1016/j.ijscr.2015.07.017. Epub 2015 Jul 26.
Stump appendicitis is one of the rare delayed complications post appendectomy with a reported incidence of 1 in 50,000 cases. Stump appendicitis can present as a diagnostic dilemma if the treating clinician is unfamiliar with this rare clinical entity. A PubMed search was conducted to identify cases of stump appendicitis following appendectomy. Sixty one cases of SA that were reported in English medical literature were analyzed.
We report a case of stump appendicitis (SA) with a systematic review and challenges encountered during the management.
The interval from original appendectomy to stump appendicitis ranged from 4 days to 50 years. SA followed appendectomy in 58% of open and 31.6% of laparoscopic procedures. SA was frequently misdiagnosed as constipation, gastroenteritis or right sided diverticulitis, therefore leading to a significant delay to surgery. Computerized Tomography diagnosed SA in 56.3% of cases. Perforation with gangrene of the stump occurred in 60%.
Stump appendicitis can represent a diagnostic dilemma if the treating physician is unfamiliar with this uncommon clinical entity. Radiological imaging is required to aid diagnosis and a completion appendectomy is the modality of treatment.
阑尾残株炎是阑尾切除术后罕见的延迟并发症之一，报告发病率为五万分之一。如果治疗医生不熟悉这种罕见的临床病症，阑尾残株炎可能会带来诊断难题。我们进行了一项PubMed检索，以确定阑尾切除术后阑尾残株炎的病例。对英文医学文献中报告的61例阑尾残株炎病例进行了分析。
我们报告一例阑尾残株炎病例，并进行系统回顾以及管理过程中遇到的挑战。
从最初阑尾切除术到阑尾残株炎的间隔时间为4天至50年。阑尾切除术后发生阑尾残株炎的情况，在开腹手术中占58%，在腹腔镜手术中占31.6%。阑尾残株炎常被误诊为便秘、肠胃炎或右侧憩室炎，因此导致手术显著延迟。计算机断层扫描在56.3%的病例中诊断出阑尾残株炎。阑尾残株穿孔伴坏疽的情况占60%。
如果治疗医生不熟悉这种不常见的临床病症，阑尾残株炎可能会成为诊断难题。需要影像学检查来辅助诊断，而阑尾残株切除术是治疗方式。
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