Servicio de Angiología y Cirugía Vascular, Complejo Asistencial Universitario de Salamanca (CAUSA), Instituto de Investigación Biomédica de Salamanca (IBSAL), Universidad de Salamanca (USAL), Paseo de San Vicente 139, 37007, Salamanca, Spain.
Servicio de Cirugía General y del Aparato Digestivo, Complejo Asistencial Universitario de Salamanca (CAUSA), Instituto de Investigación Biomédica de Salamanca (IBSAL), Universidad de Salamanca (USAL), Salamanca, Spain.
J Med Case Rep. 2021 Apr 17;15(1):203. doi: 10.1186/s13256-021-02703-x.
Abdominal aortic aneurysm and acute appendicitis occur relatively frequently in elderly patients. However, the co-occurrence of the two pathologies is very rare and serious.
We present the case of an elderly Caucasian patient who was aware of having an abdominal aortic aneurysm but refused treatment and was subsequently admitted to the hospital's emergency department with acute abdominal symptoms. A computed tomography scan raised the possibility of complication due to the characteristics of the aneurysm. The patient then agreed to emergency surgery. Laparotomy revealed the existence of an acute perforated appendicitis with a significant abscess in the right iliac fossa and an uncomplicated aneurysm. Appendectomy was performed and the abscess drained. The postoperative period passed without complications, and the patient again refused surgery for the aneurysm, which due to its anatomical characteristics was not a candidate for standard endovascular treatment.
In light of this experience, we review the literature about the relationship between abdominal aortic aneurysm and acute appendicitis.
老年患者中,腹主动脉瘤和急性阑尾炎的发病率相对较高。然而,这两种病理同时出现的情况非常罕见且严重。
我们报告了一位老年白种人患者的病例,该患者已知患有腹主动脉瘤,但拒绝治疗,随后因急性腹痛症状被收入医院急诊部。计算机断层扫描(CT)提示由于动脉瘤的特征,可能出现并发症。患者随后同意进行紧急手术。剖腹探查显示存在急性穿孔性阑尾炎,右髂窝有明显脓肿,以及未破裂的动脉瘤。进行了阑尾切除术和脓肿引流。术后期间无并发症,患者再次拒绝进行动脉瘤手术,由于其解剖学特征,该动脉瘤不符合标准的血管内治疗标准。
根据这一经验,我们回顾了关于腹主动脉瘤和急性阑尾炎之间关系的文献。