Packard Elizabeth, Groff Andrew, Shahid Zainab, Sahu Nitasa, Jain Rohit
Internal Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, USA.
Internal Medicine, Lake Erie College of Osteopathic Medicine, Erie, USA.
Cureus. 2019 May 24;11(5):e4751. doi: 10.7759/cureus.4751.
Appendicitis is the most common abdominal surgical emergency, and if left untreated, can lead to an abscess, peritonitis, or even death. The exact mechanism of appendicitis has yet to be elucidated, but the predominant theory is that different forms of luminal obstruction of the vermiform appendix lead to ischemia of the appendix wall and subsequent translocation of bacteria across the compromised mucosa, leading to transmural inflammation. The most common etiology is hyperplasia of lymphoid tissue in the mucosa, often secondary to infection and inflammation with gradual symptom onset. Rarer causes of obstruction include parasitic infiltration, fibrous bands, carcinoid syndrome, and foreign body ingestion and often have atypical or absent symptomatology, making diagnosis more challenging and complications more frequent. We present a rare case of foreign body-associated appendicitis with distal lodging in the appendix and highlight the importance of prophylactic appendectomy to avoid severe complications.
阑尾炎是最常见的腹部外科急症，若不治疗，可导致脓肿、腹膜炎甚至死亡。阑尾炎的确切发病机制尚未阐明，但主流理论认为，不同形式的阑尾管腔梗阻会导致阑尾壁缺血，随后细菌穿过受损黏膜发生移位，进而引发透壁性炎症。最常见的病因是黏膜淋巴组织增生，通常继发于感染和炎症，症状逐渐出现。少见的梗阻原因包括寄生虫浸润、纤维束带、类癌综合征和异物摄入，这些情况往往症状不典型或无症状，使得诊断更具挑战性，并发症也更常见。我们报告一例罕见的异物相关性阑尾炎，异物嵌顿于阑尾远端，并强调预防性阑尾切除术对于避免严重并发症的重要性。
