Department of Radiodiagnostics, Nobel Medical College, Biratnagar, Morang, Nepal.
Department of Surgery, Nobel Medical College, Biratnagar, Morang, Nepal.
JNMA J Nepal Med Assoc. 2022 Apr 15;60(248):396-398. doi: 10.31729/jnma.7274.
Appendicitis rarely presents with an left lower abdominal pain especially when the intestine is non-rotated or malrotated. Its diagnosis becomes quite troublesome to clinicians and delays prompt intervention. Non-rotation is the most common type of intestinal malrotation. Here, we present a case of a 40-year-old female with previously undiagnosed intestinal non-rotation with left lower abdominal pain and features of localised peritonitis. Abdominal ultrasonography and multidetector computerised tomography showed left-sided appendicitis with intestinal non-rotation. Diagnostic laparoscopy followed by explorative laparotomy and appendectomy was performed. Clinicians and surgeons are usually trained to diagnose and operate on right-sided appendix, thus, diagnosing and promptly intervening on left-sided appendicitis is quite challenging. Left-sided appendicitis must be kept in mind if a patient presents with left lower abdominal pain. Timely radiological scans like ultrasonography and computerised tomography scans help in prompt diagnosis in these cases.
appendicitis; case reports; peritonitis.
背景:当肠道未旋转或旋转不良时,阑尾炎很少表现为左下腹痛。其诊断对临床医生来说相当麻烦,并导致及时干预的延误。非旋转是最常见的肠旋转不良类型。在这里,我们报告了一例 40 岁女性,既往无肠道非旋转诊断,表现为左下腹痛和局部腹膜炎特征。腹部超声和多排计算机断层扫描显示左侧阑尾炎伴肠道非旋转。进行了诊断性腹腔镜检查,随后进行了剖腹探查和阑尾切除术。临床医生和外科医生通常接受的培训是诊断和操作右侧阑尾,因此,诊断和及时干预左侧阑尾炎具有相当大的挑战性。如果患者出现左下腹痛,必须考虑左侧阑尾炎。及时的影像学扫描,如超声和计算机断层扫描,有助于这些情况下的快速诊断。
关键词:阑尾炎;病例报告;腹膜炎。