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病例报告——机械性肠梗阻合并无绞窄及白细胞增多的阑尾炎

Case report--mechanical bowel obstruction with appendicitis without strangulation and leukocytosis.

作者信息

Khetarpal Anil, Khetarpal Ayush

机构信息

Department- General Surgery, Institution Khetarpal Hospital, India.

出版信息

Ann Med Surg (Lond). 2021 Feb 4;63:102152. doi: 10.1016/j.amsu.2021.01.100. eCollection 2021 Mar.

Abstract

Intestinal obstruction is a common surgical emergency caused by varied conditions. Acute appendicitis is considered as one of the unusual cause of intestinal obstruction especially functional and very few cases of mechanical obstruction. Here we report a Case of 62-years-old male who presented here with a clinical picture of small bowel obstruction. On laparotomy, there was a dilated gut with long appendix having inflamed tip buried into adjoining mesentery and then appendectomy was done and obstruction was relieved. Also, bowel was found to be viable hence simple appendectomy was found to be sufficient treatment. Histopathological findings was suggestive of chronic fibrosing appendicitis. Hence, in cases of bowel obstruction in an elderly patients with clinical examination which was not typical for appendicitis can be managed with laparotomy and simple appendectomy when early intervention is made to avoid the risk of ischemia and gangrenous changes in intestinal mesentery which may require resection in later stages.

摘要

肠梗阻是一种由多种情况引起的常见外科急症。急性阑尾炎被认为是肠梗阻的罕见原因之一,尤其是功能性肠梗阻,机械性肠梗阻的病例很少。在此,我们报告一例62岁男性患者,其临床表现为小肠梗阻。剖腹探查时,发现肠道扩张,阑尾较长,发炎的阑尾尖端埋入相邻系膜,随后进行了阑尾切除术,梗阻得以缓解。此外,发现肠管存活,因此单纯阑尾切除术被认为是足够的治疗方法。组织病理学检查结果提示为慢性纤维性阑尾炎。因此,对于老年肠梗阻患者,若临床检查不典型,早期进行干预,可通过剖腹探查和单纯阑尾切除术进行处理,以避免后期可能需要切除肠系膜的缺血和坏疽性改变风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/22a1/7895704/b73d9abc3fb4/gr1.jpg

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