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残端阑尾炎:诊断具有挑战性且伴有严重并发症:一例病例报告

Stump appendicitis: challenging diagnosis with serious complication: a case report.

作者信息

Alemayehu Abdi, Woyesa Ebisa, Fekadu Desalegn

机构信息

Adama Comprehensive Specialized Hospital Medical College, Adama, Ethiopia.

Department of Surgery, School of Medicine, Wollega University, Nekemte, Ethiopia.

出版信息

J Surg Case Rep. 2023 Apr 17;2023(4):rjad043. doi: 10.1093/jscr/rjad043. eCollection 2023 Apr.

Abstract

Stump appendicitis is a rare complication of appendectomy because of recurrent inflammation of the residual appendix. The diagnosis is often delayed because of low index of suspicious, which may result in serious complications. Twenty-three-year-old male patient presented with right lower quadrant abdominal pain after 7 month of appendectomy done at a hospital. On physical examination, he has right lower quadrant tenderness and rebound tenderness. Abdominal ultrasound was done with finding of blind-ended tubular noncompressible 2 cm long part of appendix with wall-to-wall diameter of 10 mm. There is also focal defect with surrounding fluid collection. With this finding, perforated stump appendicitis was diagnosed. He was operated with similar intra operative finding. The patient discharged improved after 5 days of hospital. This is first reported case in Ethiopia as far as our search is concerned. Despite past medical history of appendectomy, the diagnosis was made by means of ultrasound scan. Stump appendicitis is a rare but important complication of appendectomy, often misdiagnosed. Prompt recognition is important to avoid serious complications. This pathologic entity should always be kept in mind in case of right lower quadrant pain in patient with previous history of appendectomy.

摘要

阑尾残株炎是阑尾切除术后一种罕见的并发症,由于残留阑尾反复发炎所致。由于可疑指数低,诊断往往延迟,这可能导致严重并发症。一名23岁男性患者在一家医院行阑尾切除术后7个月出现右下腹疼痛。体格检查时,他有右下腹压痛和反跳痛。进行了腹部超声检查,发现阑尾有一段2厘米长的盲端管状结构不可压缩,壁间直径为10毫米。还有局部缺损伴周围液体积聚。根据这一发现,诊断为穿孔性阑尾残株炎。术中发现与之相似,遂对其进行了手术。患者住院5天后好转出院。就我们的检索而言,这是埃塞俄比亚首例报告病例。尽管有阑尾切除术病史,但通过超声扫描做出了诊断。阑尾残株炎是阑尾切除术后一种罕见但重要的并发症,常被误诊。及时识别对于避免严重并发症很重要。对于有阑尾切除术病史且出现右下腹疼痛的患者,应始终牢记这一病理实体。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ab74/10110352/93c42f0f0dc4/rjad043f1.jpg

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