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阑尾切除术后盲肠憩室穿孔

Perforation of Cecal Diverticulum after Appendectomy.

作者信息

Ugur Kesici

机构信息

Department of General Surgery, Faculty of Medicine, University of Beykent, Istanbul, Turkey.

出版信息

J Coll Physicians Surg Pak. 2019 Feb;29(2):175-177. doi: 10.29271/jcpsp.2019.02.175.

Abstract

Solitary cecal diverticulum was first described by Potier in 1912. Although it is a rare condition, however, there is an increased prevalence in Asian populations. The cecal diverticula are usually asymptomatic, however, 10-20% of the cases become symptomatic due to complications. The most common diverticulum-related complication is diverticulitis. Other complications include perforation, hemorrhage, and rarely intestinal obstruction. To conclude, cecal diverticulum is a rare condition that usually presents itself with complications. It is mostly diagnosed perioperatively in the cases of acute appendicitis, and rarely preoperatively. Cecal diverticulitis is commonly misdiagnosed as acute appendicitis. This is why USG, CT, and MRI are commonly used in the preoperative diagnosis. There are very few cases that are confirmed to have both cecal diverticulitis and acute appendicitis. When the condition is majorly diagnosed perioperatively after an acute appendicitis diagnosis; it should be remembered that in the case of determining cecal diverticulitis during the appendectomy, the best course of action is to simultaneously apply diverticulectomy. In this case report, a 54-year male patient is presented, where a cecal diverticulum perforation developed in the early postoperative phase following the appendectomy. At the time of admission, the patient had the complaints of distension, extensive sensitivity, and rebound. The patient underwent laparotomy and the diverticulectomy was performed with a linear stapler. In this case, the presence of a combination of acute appendicitis and cecal diverticulitis was confirmed through histopathological examination.

摘要

孤立性盲肠憩室于1912年由波捷首次描述。尽管这是一种罕见病症,但在亚洲人群中的患病率有所上升。盲肠憩室通常无症状,然而,10% - 20%的病例会因并发症而出现症状。最常见的与憩室相关的并发症是憩室炎。其他并发症包括穿孔、出血,很少见肠梗阻。总之,盲肠憩室是一种罕见病症,通常会出现并发症。它大多在急性阑尾炎病例的手术过程中被诊断出来,术前很少被诊断。盲肠憩室炎常被误诊为急性阑尾炎。这就是为什么超声、CT和MRI在术前诊断中常用。很少有病例被证实同时患有盲肠憩室炎和急性阑尾炎。当在急性阑尾炎诊断后主要在手术过程中诊断出这种病症时;应该记住,在阑尾切除术中确定为盲肠憩室炎的情况下,最佳行动方案是同时进行憩室切除术。在本病例报告中,介绍了一名54岁男性患者,其在阑尾切除术后的早期术后阶段发生了盲肠憩室穿孔。入院时,患者有腹胀、广泛压痛和反跳痛的症状。患者接受了剖腹手术,并用线性吻合器进行了憩室切除术。在本病例中,通过组织病理学检查证实了急性阑尾炎和盲肠憩室炎同时存在。

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