Börekçi Hasan, Karacabey Sinan, Sipahi Mesut, Özdemir Zeynep Tuğba, Erkoç Mustafa Fatih
Department of General Surgery, Bozok University School of Medicine, Yozgat, Turkey.
Department of Emergency, Bozok University School of Medicine, Yozgat, Turkey.
Turk J Surg. 2015 Jul 14;33(3):227-229. doi: 10.5152/UCD.2015.2963. eCollection 2017.
The cases of appendicitis take an important place in the hospital emergency departments and it must be kept in mind in the differential diagnosis of patients presenting with abdominal pain. Related to cecum, the appendix can be found in many different positions; however, it is mostly observed descending intraperitoneally (31-74%) and at the retrocecal region (26-65%). In this case report, we present the case of a 26-year-old female patient admitted to the emergency room with a colic pain in the right upper quadrant for about 2 days. Computed tomography revealed contamination in the fatty plans around the cecum and adhesive retrocecal appendicitis from the liver to the retroperitoneum. Appendectomy was performed. The pathology result was gangrenous appendicitis. In the literature, there is no similar case of appendicitis with hepatic adhesions. In conclusion, we want to emphasize that physicians and surgeons in the emergency departments must be more careful during the differential diagnosis of a patient with appendicitis and atypical symptoms and a more detailed investigation is required.
阑尾炎病例在医院急诊科占据重要地位，对于出现腹痛的患者进行鉴别诊断时必须予以考虑。阑尾与盲肠相关，可位于许多不同位置；然而，其大多经腹膜内下行（31% - 74%），且位于盲肠后区域（26% - 65%）。在本病例报告中，我们呈现了一名26岁女性患者的病例，该患者因右上腹绞痛约2天入住急诊室。计算机断层扫描显示盲肠周围脂肪层面有渗出，以及从肝脏至腹膜后的粘连性盲肠后阑尾炎。遂行阑尾切除术。病理结果为坏疽性阑尾炎。在文献中，尚无类似伴有肝脏粘连的阑尾炎病例。总之，我们想强调，急诊科的医生和外科医生在对有阑尾炎及非典型症状的患者进行鉴别诊断时必须更加谨慎，需要进行更详细的检查。
