Jaliawala Huzaifa Ali, Mannan Fatima, Gill Roger Christopher, Alvi Abdul Rehman
Research Officer, Aga Khan University Hospital, Karachi.
Department of General Surgery, Aga Khan University Hospital, Karachi.
J Pak Med Assoc. 2016 Jun;66(6):765-7.
An elderly gentleman presented to our emergency with a 10-day history of right upper quadrant pain and nausea with associated tenderness on examination. His white cell counts were raised with predominant neutrophils with ultrasound evidence of a heterogeneous sub-hepatic collection, not associated with fever, diarrhoea or vomiting. He had a similar episode 3 weeks ago, which resolved with antibiotics. Initially thought to be a perforated acute appendicitis or a liver abscess a CT scan was done to further substantiate our finding. This to the contrary revealed a perforated sub hepatic appendix. Patient was treated conservatively with IV fluids and antibiotics and the sub hepatic collection was aspirated under ultrasound guidance. He responded well to treatment and made an uneventful recovery.
一位老年男性因右上腹疼痛和恶心10天前来我院急诊科就诊，检查时伴有压痛。他的白细胞计数升高，以中性粒细胞为主，超声显示肝下有不均匀性积液，无发热、腹泻或呕吐症状。3周前他有过类似发作，使用抗生素后症状缓解。最初考虑为穿孔性急性阑尾炎或肝脓肿，遂进行CT扫描以进一步证实诊断。结果却显示为肝下阑尾穿孔。患者接受了静脉输液和抗生素保守治疗，并在超声引导下对肝下积液进行了抽吸。他对治疗反应良好，康复过程顺利。
