Okur Selahattin Koray, Koca Yavuz Savaş, Yıldız İhsan, Barut İbrahim
Department of General Surgery, Suleyman Demirel University Medical Faculty, 32260 Isparta, Turkey.
Case Rep Emerg Med. 2016;2016:3231862. doi: 10.1155/2016/3231862. Epub 2016 Mar 16.
Introduction. Acute appendicitis is the most common cause of acute abdomen, but atypical appendicitis may lead to delayed diagnosis and related complications. In this report, we present a very rare case of acute appendicitis causing right hydronephrosis. Case Report. A 54-year-old male patient who had been receiving antibiotic therapy due to the diagnosis of urinary tract infection for the last one week but had no clinical improvement was admitted to the emergency service. Abdominal computed tomography (CT) showed right hydronephrosis and a pelvic abscess. After appendectomy and abscess drainage had been performed, hydronephrosis was completely recovered. Discussion. The use of appendicitis scoring systems, abdominal ultrasonography (USG), abdominal CT, and diagnostic laparoscopy can be useful for the diagnostic process in patients presenting with acute abdomen. In our patient, we considered that the surgical treatment was delayed since the symptoms of acute appendicitis were suppressed by the antibiotic therapy that was being administered due to the complaints including symptoms of urinary tract infections. Conclusion. Atypical appendicitis may cause a delay in the diagnosis of acute appendicitis and thus may lead to serious complications such as right hydronephrosis, prolonged hospital stay, increased morbidity and mortality, and increased antibiotic resistance.
引言。急性阑尾炎是急腹症最常见的病因,但非典型阑尾炎可能导致诊断延误及相关并发症。在本报告中,我们呈现了一例极为罕见的急性阑尾炎导致右肾积水的病例。病例报告。一名54岁男性患者,因在过去一周被诊断为尿路感染而接受抗生素治疗,但临床症状无改善,遂入住急诊。腹部计算机断层扫描(CT)显示右肾积水和盆腔脓肿。在进行阑尾切除和脓肿引流术后,肾积水完全恢复。讨论。阑尾炎评分系统、腹部超声检查(USG)、腹部CT及诊断性腹腔镜检查对急腹症患者的诊断过程可能有用。在我们的患者中,我们认为由于因包括尿路感染症状在内的主诉而正在使用的抗生素治疗抑制了急性阑尾炎的症状,导致手术治疗延迟。结论。非典型阑尾炎可能导致急性阑尾炎诊断延迟,进而可能导致严重并发症,如右肾积水、住院时间延长、发病率和死亡率增加以及抗生素耐药性增加。