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老年患者复杂急性阑尾炎表现为腹壁脓肿:一例报告。

Complicated acute appendicitis presenting as an abscess in the abdominal wall in an elderly patient: A case report.

作者信息

Souza Ibrahim Massuqueto Andrade Gomes de, Nunes Diego Antonio De Almeida, Massuqueto Carolina Morandim Granito, Veiga Marcos Alberto de Mendonça, Tamada Horacio

机构信息

Division of General Surgery, Hospital de Base, Porto Velho City, Brazil.

Division of General Surgery, Hospital João Paulo II, Porto Velho City, Brazil.

出版信息

Int J Surg Case Rep. 2017;41:5-8. doi: 10.1016/j.ijscr.2017.09.023. Epub 2017 Oct 4.

Abstract

INTRODUCTION

Appendicitis is a common cause of acute abdomen; however, the classic clinical signs are not often present, and it has unusual presentations. Thus, its diagnosis can be challenging.

PRESENTATION OF CASE

We describe the case of an elderly man who presented with right abdominal wall abscess with spontaneous drainage in the emergency department. Since we suspected a subjacent abdominal pathology, we performed surgery, and intraoperatively, we observed that the Appendix tip had invaded the abdominal wall.

DISCUSSION

This patient had a challenging diagnostic process and surgical visualization of the appendicular tip invading the abdominal wall was an important characteristic in proving the cause of the abdominal wall abscess.

CONCLUSION

The onset of an abdominal wall abscess without a known cause needs to be thoroughly investigated, with consideration of a subjacent abdominal cause and appendicitis necessitatis.

摘要

引言

阑尾炎是急腹症的常见病因;然而,经典的临床体征并不常出现,且其表现不寻常。因此,其诊断可能具有挑战性。

病例介绍

我们描述了一名老年男性的病例,他在急诊科出现右腹壁脓肿并自发引流。由于我们怀疑其下方存在腹部病变,遂进行了手术,术中我们观察到阑尾尖端已侵入腹壁。

讨论

该患者的诊断过程具有挑战性,阑尾尖端侵入腹壁的手术所见是证明腹壁脓肿病因的一个重要特征。

结论

对于病因不明的腹壁脓肿发病,需要进行全面调查,考虑其下方的腹部病因及必要性阑尾炎。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa1f/5742009/9c9cba2e0171/gr1.jpg

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