Kurtzman Nicholas, Adler Jamie, Ketterer Andrew, Lewis Jason
Beth Israel Deaconess Medical Center, Department of Emergency Medicine, Boston, Massachusetts.
Clin Pract Cases Emerg Med. 2021 Feb;5(1):66-69. doi: 10.5811/cpcem.2020.11.49601.
Appendicitis is a common disease, and as we have improved in early diagnosis and management of this disease process, late stage complications have become extremely rare, but can have indolent presentations.
A 37-year-old male with no past medical history presented to the emergency department (ED) with vague abdominal pain as well as 12 days of cyclical fever. He had no significant findings on laboratory workup with the exception of a mild aspartate transaminase and alanine transaminase and relative neutrophilia between outpatient, urgent care, and ultimate ED visit. His ED workup included cross-sectional imaging of his abdomen revealing multiple liver abscesses and septic thrombophlebitis secondary to ruptured appendicitis.
Liver abscesses and septic thrombophlebitis are an extremely rare complication of appendicitis that has only been documented twice previously.
阑尾炎是一种常见疾病,随着我们在该疾病早期诊断和治疗方面的进步,晚期并发症已极为罕见,但可能有隐匿的表现。
一名37岁无既往病史的男性因腹部隐痛以及持续12天的周期性发热就诊于急诊科。除门诊、紧急护理及最终急诊科就诊时轻度天冬氨酸转氨酶和丙氨酸转氨酶升高以及相对中性粒细胞增多外,其实验室检查无显著异常。他在急诊科的检查包括腹部横断面成像,显示多发性肝脓肿及阑尾破裂继发的感染性血栓性静脉炎。
肝脓肿和感染性血栓性静脉炎是阑尾炎极为罕见的并发症,此前仅有两次记录。