Syahputra Dian Adi, Isa Munthadar M, Jailani Muhammad
Pediatric Surgery Division, Department of Surgery, Faculty of Medicine, Syiah Kuala University, Dr. Zainoel Abidin Hospital, Banda Aceh, Aceh, Indonesia.
Plastic Surgery Division, Department of Surgery, Faculty of Medicine, Syiah Kuala University, Dr. Zainoel Abidin Hospital, Banda Aceh, Aceh, Indonesia.
Ann Med Surg (Lond). 2021 Jan 5;62:13-15. doi: 10.1016/j.amsu.2020.12.034. eCollection 2021 Feb.
Acute appendicitis is one of the most common surgical diseases. Perforated appendicitis resulting in catastrophic complication because of a burst abdomen with necrotizing fasciitis of the abdominal wall is exceedingly a rare case.
A 13-year-old girl with perforated appendicitis who had undergone laparotomy had to experience a burst abdomen with necrotizing fasciitis of the abdominal wall. The patient has temporarily closed the abdominal cavity with a urine bag (modified Bogota bag). After 23 times replacement of the Bogota bag and the condition of the sepsis and nutrition had improved, the abdominal wall reconstruction was performed by carrying out two random rotational flaps to close the abdominal defect. One year later, the patient came for ileocolostomy closure; then the patient was sent home with uneventful condition.
Perforated appendicitis is a type of acute appendicitis with a low morbidity rate. Compared to other complications, burst abdomen and necrotizing fasciitis (NF) in perforated appendicitis are exceptionally rare events. Surgery with sepsis and recurrent intra-abdominal abscesses as a result of previous surgery are the causes of burst abdomen. The use of abdominal drainage has also been shown to cause NF. Both of these conditions will increase the cost and length of stay, and reduce the quality of life. The rotational flap procedure is the procedure of choice for a large burst abdomen.
Surgeons should and have to perform a meticulous operation to prevent catastrophic complication and to increase the quality of life.
急性阑尾炎是最常见的外科疾病之一。因阑尾穿孔导致腹壁坏死性筋膜炎的灾难性并发症极为罕见。
一名13岁阑尾穿孔女孩接受了剖腹手术，术后出现腹壁坏死性筋膜炎伴腹腔破裂。患者用尿袋（改良波哥大袋）临时封闭腹腔。在更换23次波哥大袋且败血症和营养状况改善后，通过进行两个随意旋转皮瓣来闭合腹壁缺损，完成腹壁重建。一年后，患者前来关闭回结肠造口；随后患者情况平稳出院。
穿孔性阑尾炎是急性阑尾炎的一种，发病率较低。与其他并发症相比，穿孔性阑尾炎中的腹腔破裂和坏死性筋膜炎（NF）极为罕见。手术伴发败血症以及既往手术导致的复发性腹腔脓肿是腹腔破裂的原因。使用腹腔引流也已证明会导致坏死性筋膜炎。这两种情况都会增加费用和住院时间，并降低生活质量。旋转皮瓣手术是大面积腹腔破裂的首选手术方法。
外科医生应该且必须进行细致的手术，以防止灾难性并发症并提高生活质量。
