Takabatake Kazuya, Imanishi Tsutomu, Yoshikawa Tetsuji
Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Department of Surgery, Soseikai General Hospital, Kyoto, Japan.
BMJ Case Rep. 2018 Nov 28;11(1):e227178. doi: 10.1136/bcr-2018-227178.
Acute appendicitis is one of the most common abdominal emergencies worldwide. Uncomplicated appendicitis (UA), which does not involve perforation or peritonitis, has recently been treated with antibiotic therapy. Here, we report a case of acute eosinophilic appendicitis (AEA) that simulated UA and did not respond to antibiotic therapy. A 20-year-old Japanese woman emergently presented with the chief complaint of pain at the right iliac fossa. CT showed only swelling of the appendix. She was diagnosed with UA, and she received antibiotic therapy initially. However, the treatment was not effective and appendectomy was performed. The final histopathological diagnosis was AEA. The findings of this case suggest that AEA is likely to be diagnosed as UA. As AEA can simulate UA, the possibility of AEA should be considered when antibiotic therapy is not effective.
急性阑尾炎是全球最常见的腹部急症之一。不伴有穿孔或腹膜炎的单纯性阑尾炎(UA),近来采用抗生素治疗。在此,我们报告一例模拟UA且对抗生素治疗无反应的急性嗜酸性粒细胞性阑尾炎(AEA)病例。一名20岁日本女性因右下腹疼痛为主诉紧急就诊。CT显示仅阑尾肿胀。她被诊断为UA,并最初接受了抗生素治疗。然而,治疗无效,遂行阑尾切除术。最终组织病理学诊断为AEA。该病例结果提示AEA可能被误诊为UA。由于AEA可模拟UA,当抗生素治疗无效时应考虑AEA的可能性。