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一名老年患者的急性坏疽性阑尾炎伴阑尾周围脓肿的闭塞形式:病例报告及文献综述

An Occlusive Form of Acute Gangrenous Appendicitis With Periappendicular Abscess in an Elderly Patient: A Case Report and Literature Review.

作者信息

Najm Alfred, Bejenaru Irina M, Manolescu Stefania L, Iliescu Ramona, Cretoiu Sanda Maria, Gaspar Bogdan S

机构信息

Surgery, Emergency Clinical Hospital/Carol Davila University of Medicine and Pharmacy, Bucharest, ROU.

Surgery Clinic, Emergency Clinical Hospital, Bucharest, ROU.

出版信息

Cureus. 2023 Mar 16;15(3):e36213. doi: 10.7759/cureus.36213. eCollection 2023 Mar.

Abstract

Acute appendicitis represents one of the common causes of admission to the emergency department. In rare cases, patients with appendicitis can suffer complications such as intestinal obstruction. These particular cases of occlusive appendicitis with a periappendicular abscess usually occur in elderly patients and can develop in an aggressive form, nonetheless with a favorable evolution. We present a case of an 80-year-old male patient, reporting symptoms similar to an occlusive digestive pathology: abdominal pain, intestinal transit disorders, and fecal vomiting. A computerized tomography scan suggested a mechanical bowel obstruction. The patient had an exploratory laparotomy indication to find the cause of the obstruction. The peritoneal cavity inspection revealed an occlusive form of acute gangrenous appendicitis with a periappendicular abscess. An appendectomy was performed. In conclusion, as surgeons, we must always take into consideration that acute appendicitis can represent a cause of intestinal obstruction, especially in elderly patients.

摘要

急性阑尾炎是急诊入院的常见原因之一。在罕见情况下,阑尾炎患者可能会出现肠梗阻等并发症。这些伴有阑尾周围脓肿的闭塞性阑尾炎特殊病例通常发生在老年患者中,且可能以侵袭性形式发展,不过病情转归良好。我们报告一例80岁男性患者,其表现出类似于闭塞性消化系统疾病的症状:腹痛、肠道转运障碍和粪性呕吐。计算机断层扫描提示机械性肠梗阻。该患者有进行剖腹探查以查明梗阻原因的指征。腹腔检查发现急性坏疽性阑尾炎伴阑尾周围脓肿的闭塞形式。遂行阑尾切除术。总之,作为外科医生,我们必须始终考虑到急性阑尾炎可能是肠梗阻的一个原因,尤其是在老年患者中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc75/10105286/3368da180e51/cureus-0015-00000036213-i01.jpg

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