Biçer Şenol, Çelik Ali
Department of Pediatric Surgery, Erzincan University, Medical School, Erzincan, Turkey.
Department of General Surgery, Konya State Hospital, Konya, Turkey.
Am J Case Rep. 2015 Aug 27;16:574-6. doi: 10.12659/AJCR.894311.
In patients with intestinal malrotation, the diagnosis of acute appendicitis can be difficult due to atypical presentation. Duodenal obstruction caused by acute appendicitis with the presence of malrotation has rarely been reported in children.
We report the case of a 14-year-old male patient with bilious vomiting and abdominal distension. A diagnosis could not be made by computed tomography, ultrasonography, or endoscopy. We observed a dilated stomach and malrotation in laparotomy. The caecum was in the right upper quadrant, and an inflamed appendix was located in the subhepatic region. After the appendectomy, the cecum was mobilized and fixed in the right lower quadrant.
In children with intestinal malrotation, acute appendicitis can present as duodenal obstruction without abdominal pain, and standard imaging methods can miss the correct diagnosis.
在肠旋转不良患者中，由于表现不典型，急性阑尾炎的诊断可能会很困难。急性阑尾炎合并旋转不良导致十二指肠梗阻在儿童中鲜有报道。
我们报告一例14岁男性患者，出现胆汁性呕吐和腹胀。计算机断层扫描、超声检查或内镜检查均无法做出诊断。我们在剖腹手术中观察到胃扩张和旋转不良。盲肠位于右上腹，发炎的阑尾位于肝下区域。阑尾切除术后，将盲肠游离并固定于右下腹。
在肠旋转不良的儿童中，急性阑尾炎可表现为无腹痛的十二指肠梗阻，标准影像学方法可能会漏诊。
