Hu Qiang, Shi Jianfeng, Sun Yuanshui
Department of General Surgery, Tongde Hospital of Zhejiang Province, Hangzhou, China.
Front Surg. 2022 Aug 24;9:896116. doi: 10.3389/fsurg.2022.896116. eCollection 2022.
Left-sided appendicitis is a rare condition, and we report a patient with left abdominal heterotopia of the right colon complicated by acute appendicitis in the left lower quadrant.
A 39-year-old male was admitted to hospital following left lower abdominal pain for 1 day. Imaging examination by abdominal CT showed that the appendix was not clearly seen, and a mass was found in the left lower abdomen. Because the patient's abdominal pain was severe and the current diagnosis was not clear, after soliciting the patient's consent, we performed laparoscopic exploration. This exploration revealed that the cecum and ascending colon were located in the left iliac fossa, the appendix was swollen, the length of the appendix was approximately 6 cm, the diameter of the appendix was approximately 1 cm, and there was pus moss attached to the surface. We performed a laparoscopic appendectomy; the procedure was uneventful and the patient was discharged 3 days after the procedure.
Left-sided appendicitis is a rare condition and is therefore easy to misdiagnose. Wrong diagnosis can lead to serious complications and endanger the patient's life. Therefore, a full combination of laboratory tests and CT scan is required. If still no diagnosis can be made correctly, a laparoscopic exploration needs to be performed in a timely manner. This case teaches us that when we encounter a patient with severe left abdominal pain that cannot be definitely diagnosed, we need to be vigilant and perform timely laparoscopic exploration when necessary.
左侧阑尾炎是一种罕见病症,我们报告一例右半结肠左下腹异位并伴有左下腹急性阑尾炎的患者。
一名39岁男性因左下腹疼痛1天入院。腹部CT影像检查显示阑尾显示不清,左下腹发现一个肿物。由于患者腹痛严重且当前诊断不明确,征得患者同意后,我们进行了腹腔镜探查。探查发现盲肠和升结肠位于左髂窝,阑尾肿胀,阑尾长度约6 cm,阑尾直径约1 cm,表面附着脓性苔。我们进行了腹腔镜阑尾切除术;手术过程顺利,患者术后3天出院。
左侧阑尾炎是一种罕见病症,因此容易误诊。错误诊断可导致严重并发症并危及患者生命。因此,需要综合实验室检查和CT扫描。如果仍无法正确诊断,则需要及时进行腹腔镜探查。该病例告诉我们,当遇到左下腹剧痛且无法明确诊断的患者时,我们需要保持警惕,必要时及时进行腹腔镜探查。