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一种罕见的临床病症:残端阑尾炎。病例报告及文献全面综述

A rare clinical entity: stump appendicitis. Case report and complete review of literature.

作者信息

Geraci G, Lena A, D'Orazio B, Cudia B, Rizzuto S, Modica G

机构信息

School of Medicine and Surgery, Section of General and Thoracic Surgery (Chair: Giuseppe Modica, MD), University Hospital of Palermo, Palermo, Italy.

出版信息

Clin Ter. 2019 Nov-Dec;170(6):e409-e417. doi: 10.7417/CT.2019.2167.

Abstract

BACKGROUND

Stump appendicitis is a rare delayed complication post-appendectomy and it represents a diagnostic problem as clinicians are often not very familiar with this pathology.

MATERIALS AND METHODS

One case of stump appendicitis has been reported in a 54 year old woman, whose acute phase was conservatively treated in our Department. A review of Medline literature was also carried out, from 1945 to 2015, showing 111 cases of stump appendicitis.

RESULTS

Stump appendicitis has been reported after either open or laparoscopic appendectomy, in a range between days to several years from the first procedure. Nowadays, it is not considered yet as a possible differential diagnosis in patients with pain in the right iliac fossa previously undergone appendectomy. For this reason, the diagnosis can be delayed and complications such as acute abdomen, perforation, sepsis can occur. Completion appendectomy is the treatment of choice for stump appendicitis.

CONCLUSIONS

The aim of this article is to underline the importance of stump appendicitis. Clinicians should be aware of the possibility of SA and they should confirm any clinical suspicion throughout radiologic images, in order to promptly recognize this entity and to avoid the related complications.

摘要

背景

残端阑尾炎是阑尾切除术后一种罕见的延迟性并发症,由于临床医生对这种病理情况通常不太熟悉,它成为了一个诊断难题。

材料与方法

本文报道了一名54岁女性的残端阑尾炎病例,其急性期在我科接受了保守治疗。我们还对1945年至2015年的Medline文献进行了回顾,共发现111例残端阑尾炎病例。

结果

无论是开腹阑尾切除术还是腹腔镜阑尾切除术后均有残端阑尾炎的报道,时间范围从首次手术数天至数年不等。目前,对于既往接受过阑尾切除术且右下腹疼痛的患者,残端阑尾炎尚未被视为一种可能的鉴别诊断。因此,诊断可能会延迟,进而可能发生诸如急腹症、穿孔、脓毒症等并发症。阑尾残端切除术是残端阑尾炎的首选治疗方法。

结论

本文旨在强调残端阑尾炎的重要性。临床医生应意识到残端阑尾炎的可能性,并应通过影像学检查来确认任何临床怀疑,以便及时识别该病症并避免相关并发症。

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