Department of General Surgery,Tianjin First Central Hospital, Tianjin-China.
Ulus Travma Acil Cerrahi Derg. 2021 Jul;27(4):483-485. doi: 10.14744/tjtes.2020.92836.
Here, we report the case of a 75-year-old male with abdominal pain who was admitted to our Emergency Department. Computed tomography (CT) scan revealed torsion of the mesenteric root with fluid surrounding the area. Emergency laparotomy, performed under general anesthesia, revealed appendiceal abscess with intestinal malrotation. Appendicectomy was performed after the torsional mesentery restoration. Antibiotics and other symptomatic treatments were administered postoperatively. The patient recovered well and was discharged one week after surgery. Intestinal malrotation is more common in neonates than in adults. The diagnosis of appendicitis could be further obscured by intestinal malrotation. Therefore, the rare situation of intestinal malrotation and ectopic appendicitis in the abdomen should be considered in cases with an absence of right lower abdominal pain, where preoperative abdominal CT shows mesenteric volvulus and the surrounding intestinal wall is thickened and demonstrating exudation.
在这里，我们报告了一例 75 岁男性腹痛患者，他因该症状被收入我院急诊科。计算机断层扫描（CT）显示肠系膜根部扭转，周围有液体环绕。在全身麻醉下进行了紧急剖腹手术，发现阑尾脓肿伴肠旋转不良。扭转的肠系膜复位后进行了阑尾切除术。术后给予抗生素和其他对症治疗。患者术后恢复良好，一周后出院。肠旋转不良在新生儿中比在成人中更为常见。肠旋转不良可能使阑尾炎的诊断更加复杂。因此，对于无右下腹痛的患者，术前腹部 CT 显示肠系膜扭转，周围肠壁增厚并渗出，应考虑罕见的腹部肠旋转不良和异位阑尾炎情况。
