Mori Takaaki, Shin Teng S, Ong Gene Y K
KK Women's and Children's Hospital, Department of Emergency Medicine, Singapore.
Clin Pract Cases Emerg Med. 2019 Mar 18;3(2):149-152. doi: 10.5811/cpcem.2019.2.41682. eCollection 2019 May.
A 10-year-old male presented to our pediatric emergency department with progressive, colicky abdominal pain for one day, associated with fever and non-bilious vomiting. He had a guarded abdomen with sluggish bowel sounds. He was noted to have poor perfusion with tachycardia, which resolved with fluid resuscitation. Abdominal radiograph demonstrated the presence of a circular radiopaque structure at the right hypochondrial region. Point-of-care ultrasound revealed an ascending appendicitis with signs of perforation, which was unusually located just at the inferior edge of the liver, over the right hypochondrium. The patient was immediately admitted to the surgical intermediate care unit. Urgent laparoscopic appendectomy was successfully performed, and the child was discharged well.
一名10岁男性因进行性绞痛性腹痛一天，伴有发热和非胆汁性呕吐，前来我院儿科急诊科就诊。他腹部有压痛，肠鸣音减弱。发现他存在灌注不良伴心动过速，经液体复苏后症状缓解。腹部X线片显示右季肋区有一个圆形不透光结构。床旁超声显示为升结肠阑尾炎伴穿孔迹象，异常位于肝脏下缘、右季肋区上方。患者立即被收入外科中级护理病房。紧急进行了腹腔镜阑尾切除术，患儿康复出院。
