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内镜逆行阑尾炎治疗术在亚急性阑尾炎伴脓肿中的应用:一项综合病例研究及创新性见解

Endoscopic Retrograde Appendicitis Therapy in Subacute Appendicitis With Abscess: A Comprehensive Case Study and Innovative Insights.

作者信息

Raxwal Bhuvi, Payappagoudar Jayashree, Patel Satish

机构信息

Medicine, Access Health Care Physicians, Zephyrhills, USA.

Internal Medicine, BayCare Health System, New Port Richey, USA.

出版信息

Cureus. 2024 Feb 12;16(2):e54087. doi: 10.7759/cureus.54087. eCollection 2024 Feb.

Abstract

This case report explores the feasibility and efficacy of endoscopic retrograde appendicitis therapy (ERAT) in treating a 42-year-old female with subacute appendicitis complicated by an abscess. The patient, initially presenting with abdominal pain, underwent an endoscopic intervention involving drainage, irrigation, and stent placement in the appendix. The study discusses the patient's successful outcome, emphasizing the role of ERAT in managing complicated appendicitis with abscesses. The report outlines the case presentation with the initial misdiagnosis of cecal intussusception. The endoscopic procedure involved identifying a partially prolapsed appendix, spontaneous drainage of purulent discharge, and subsequent stent placement to facilitate drainage while awaiting definitive surgery. The patient's positive response to ERAT was marked by pain reduction and a follow-up CT scan confirming the absence of an abscess and a normal appendix. The case report asserts that ERAT emerges as a promising alternative to immediate appendectomy for patients with subacute appendicitis complicated by abscesses, enhancing symptom relief and reducing major adverse events.

摘要

本病例报告探讨了内镜逆行阑尾炎治疗术(ERAT)治疗一名42岁亚急性阑尾炎合并脓肿女性患者的可行性和疗效。该患者最初表现为腹痛,接受了包括阑尾引流、冲洗和支架置入的内镜干预。该研究讨论了患者的成功治疗结果,强调了ERAT在处理合并脓肿的复杂性阑尾炎中的作用。报告概述了病例情况,最初误诊为盲肠套叠。内镜手术包括识别部分脱垂的阑尾、脓性分泌物的自发引流,以及随后放置支架以促进引流,同时等待确定性手术。患者对ERAT的积极反应表现为疼痛减轻,后续CT扫描证实脓肿消失且阑尾正常。该病例报告称,对于亚急性阑尾炎合并脓肿的患者,ERAT成为直接阑尾切除术的一种有前景的替代方法,可增强症状缓解并减少主要不良事件。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/246d/10937217/36f2f3126984/cureus-0016-00000054087-i01.jpg

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