Lovrenski Jovan, Jokić Radoica, Varga Ivan
Radiology Department, Institute for Children and Adolescents Health Care of Vojvodina, Medical Faculty, University of Novi Sad, Hajduk Veljkova 10, 21000, Novi Sad, Serbia.
Pediatric Surgery Department, Institute for Children and Adolescents Health Care of Vojvodina, Medical Faculty, University of Novi Sad, Hajduk Veljkova 10, 21000, Novi Sad, Serbia.
J Clin Ultrasound. 2016 Jul 8;44(6):395-398. doi: 10.1002/jcu.22337. Epub 2016 Feb 18.
Prompt and accurate diagnosis of perforated appendicitis is crucial for proper and timely treatment. The appendix, however, cannot always be identified with sonography (US). We report the case of a 2-year-old child with atypical clinical presentation, and US detection of a free appendicolith as a sign of perforated appendicitis, without visualization of the appendix itself. Laparoscopy revealed a retrocecal, gangrenous, perforated appendix with autoamputation, fibrinopurulent peritonitis, and a free appendicolith within the abdominal fluid. US detection of a free appendicolith in a child is a very rare, but unequivocal sign of perforated appendicitis, which should be sought. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 44:395-398, 2016.
及时准确地诊断穿孔性阑尾炎对于恰当且及时的治疗至关重要。然而，超声检查（US）并非总能识别出阑尾。我们报告了一例2岁儿童的病例，其临床表现不典型，超声检查发现游离阑尾结石作为穿孔性阑尾炎的征象，但未见到阑尾本身。腹腔镜检查显示盲肠后位坏疽穿孔性阑尾伴自截、纤维脓性腹膜炎以及腹腔积液内有游离阑尾结石。超声检查发现儿童体内有游离阑尾结石是穿孔性阑尾炎一种非常罕见但明确的征象，应予以寻找。© 2016威利期刊公司。《临床超声杂志》2016年第44卷，第395 - 398页
