Khilji Muhammad Faisal, Zia Ullah Qazi
Department of Emergency Medicine, Sultan Qaboos University Hospital, Muscat, Oman.
Case Rep Emerg Med. 2017;2017:8245046. doi: 10.1155/2017/8245046. Epub 2017 Mar 1.
Appendicitis and trauma both present in emergency department commonly but their presentation together in the same patient is unusual. We present a case of a middle-aged man brought by emergency medical services (EMS) to the emergency department with complaints of abdominal pain after he was involved in motor vehicle collision. He was perfectly fine before the accident. His primary survey was normal. Secondary survey revealed tenderness in right iliac fossa with seat belt mark overlying it. Computerized tomography (CT) of the abdomen and pelvis was performed which showed 8 mm thickening of appendix with minimal adjacent fat stranding. There is also subcutaneous fat stranding of anterior lower abdominal wall possibly due to bruising. Impression of posttraumatic seat belt compression appendicitis was made. Laparoscopic appendectomy was done and patient recovered uneventfully. Histopathology showed inflamed appendix, proving it to be a case of seat belt compression appendicitis.
阑尾炎和创伤在急诊科都很常见，但同一患者同时出现这两种情况并不常见。我们报告一例中年男性，他在机动车碰撞事故后被紧急医疗服务（EMS）送往急诊科，主诉腹痛。事故发生前他一切正常。他的初步检查正常。二次检查发现右髂窝有压痛，上面有安全带痕迹。对腹部和骨盆进行了计算机断层扫描（CT），结果显示阑尾增厚8毫米，相邻脂肪有轻微渗出。下腹部前壁也有皮下脂肪渗出，可能是由于瘀伤所致。诊断为创伤后安全带压迫性阑尾炎。进行了腹腔镜阑尾切除术，患者恢复顺利。组织病理学显示阑尾发炎，证实这是一例安全带压迫性阑尾炎。
