Slovis T L, Haller J O, Cohen H L, Berdon W E, Watts F B
Department of Radiology, Children's Hospital of Michigan, Detroit 48201.
Radiology. 1989 Jun;171(3):823-5. doi: 10.1148/radiology.171.3.2655006.
Five children with complicated appendiceal inflammatory disease are reported. They presented with nonspecific signs and symptoms, but three had liver abscess and two had inflammation of the portal vein. The inflamed portal vein may act as a conduit to the liver for bacteria, or it may become thrombosed and cause portal hypertension and hypersplenism. In one child, symptomatic portal hypertension developed 10 years after the initial disease. In children, an ultrasonic finding of a focal liver mass of low-to-mixed echogenicity or the presence of low-attenuation areas on computed tomographic scans should suggest the possibility of a hepatic abscess, and the radiologist has a major role in suggesting complicated inflammatory disease of the appendix as the cause. Similarly, when portal vein thrombosis or portal hypertension are found, the radiologist should consider complicated inflammatory disease of the appendix as the cause.
本文报告了5例患有复杂性阑尾炎性疾病的儿童。他们表现出非特异性的体征和症状，但其中3例有肝脓肿，2例有门静脉炎症。发炎的门静脉可能成为细菌进入肝脏的通道，也可能形成血栓并导致门静脉高压和脾功能亢进。在1例儿童中，初始疾病10年后出现了有症状的门静脉高压。对于儿童，超声检查发现肝脏有低至混合回声的局灶性肿块或计算机断层扫描显示有低密度区，应提示肝脓肿的可能性，放射科医生在提示阑尾复杂性炎性疾病为病因方面起着主要作用。同样，当发现门静脉血栓形成或门静脉高压时，放射科医生应考虑阑尾复杂性炎性疾病为病因。
