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一名年轻女性因急性阑尾炎行腹腔镜阑尾切除术后,病理诊断为阑尾憩室炎

Appendiceal Diverticulitis in a Young Female Diagnosed on Pathology after Laparoscopic Appendectomy for Acute Appendicitis.

作者信息

Onafowokan Oluwatobi O, Khairat Aboubakr, Bonatti Hugo J R

机构信息

University of Maryland Community Medical Group, Easton, MD, USA.

Royal Lancaster Infirmary, Lancaster, UK.

出版信息

Case Rep Med. 2021 Mar 8;2021:2508956. doi: 10.1155/2021/2508956. eCollection 2021.

Abstract

. Appendiceal diverticulitis is a rare cause of inflammation of the appendix, which may mimic acute appendicitis. Its diagnosis is often delayed, and its occurrence carries an increased risk of significant complications, such as perforation. . A 23-year-old woman presented with sudden onset, severe, right lower quadrant abdominal pain and nausea. Her WBC was elevated, and abdominal CT showed findings indicative of acute appendicitis with a 13 mm fluid-filled appendix and local stranding. During laparoscopic appendectomy, significant inflammation was found around the appendix with some mucous material around the tip. The appendix base was not involved, and an endoloop was used to secure the stump. No other intra-abdominal abnormalities were observed. The patient recovered uneventfully. Pathology showed no classic appendicitis but appendiceal diverticulitis with signs of perforation. . Appendiceal diverticulitis is a rare condition which cannot be distinguished from acute appendicits clinically and on imaging. Diagnosis may be established based on pathology such as in our case. Appendectomy is indicated in appendiceal diverticulitis, and an appendix diverticulum is incidentally found during surgery or other investigations. This is due to the increased risk of perforation and the reported development of malignant tumors, including the appendix carcinoid.

摘要

阑尾憩室炎是阑尾炎症的一种罕见病因,可能酷似急性阑尾炎。其诊断常常延迟,且其发生会增加诸如穿孔等严重并发症的风险。一名23岁女性突发严重的右下腹腹痛和恶心。她的白细胞计数升高,腹部CT显示有提示急性阑尾炎的表现,阑尾有13毫米充满液体,周围有局部条索状影。在腹腔镜阑尾切除术中,发现阑尾周围有明显炎症,阑尾尖端周围有一些黏液物质。阑尾根部未受累,使用内镜圈套器固定残端。未观察到其他腹腔内异常情况。患者恢复顺利。病理检查显示无典型阑尾炎,但为阑尾憩室炎并有穿孔迹象。阑尾憩室炎是一种罕见疾病,在临床和影像学上无法与急性阑尾炎区分。如我们病例所示,诊断可基于病理检查确定。阑尾憩室炎需行阑尾切除术,阑尾憩室可在手术或其他检查中偶然发现。这是由于穿孔风险增加以及报道的包括阑尾类癌在内的恶性肿瘤的发生。

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