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一例罕见的阑尾残端穿孔病例:病例报告

An unusual case of perforated stump appendicitis: A case report.

作者信息

Basukala Sunil, Pathak Bishnu Deep, Pahari Soumya, Gurung Suman, Basukala Bikram, Rayamajhi Bikash Bahadur, Thapa Narayan

机构信息

Department of Surgery, Shree Birendra Hospital, Chhauni, Kathmandu, 44600, Nepal.

Nepalese Army Institute of Health Sciences (NAIHS), Sanobharyang, 44600, Kathmandu, Nepal.

出版信息

Ann Med Surg (Lond). 2022 Mar 9;76:103447. doi: 10.1016/j.amsu.2022.103447. eCollection 2022 Apr.

Abstract

INTRODUCTION AND IMPORTANCE

The stump appendicitis is a rare complication with incidence of 1 in 50,000 appendectomy cases.

CASE PRESENTATION

Patient with a history of emergency open appendectomy one year back presented with symptoms as that of acute appendicitis like pain abdomen localized in right iliac fossa, nausea, vomiting and anorexia. Complete blood count showed leukocytosis.

CLINICAL DISCUSSION

Aside from classical clinical symptoms similar to acute appendicitis other causes of acute abdominal pain were ruled out with clinical laboratory and radiological investigations. This creates a dilemma and delay in diagnosis if investigations are not done promptly.

CONCLUSION

Due to prior surgical history of appendectomy and low index of suspicion, the diagnosis of stump appendicitis is often delayed which may result in serious complications like stump gangrene, perforation and peritonitis.

摘要

引言与重要性

残端阑尾炎是一种罕见的并发症,在每50000例阑尾切除病例中的发生率为1例。

病例介绍

一名患者一年前接受了急诊开放性阑尾切除术,现出现类似急性阑尾炎的症状,如右下腹疼痛、恶心、呕吐和厌食。血常规显示白细胞增多。

临床讨论

除了与急性阑尾炎相似的典型临床症状外,通过临床实验室和影像学检查排除了其他急性腹痛的原因。如果不及时进行检查,这会造成诊断上的困境和延误。

结论

由于既往有阑尾切除手术史且怀疑指数较低,残端阑尾炎的诊断常常延迟,这可能导致严重并发症,如残端坏疽、穿孔和腹膜炎。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/21f6/8927796/7e835f453c4e/gr1.jpg

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