El Bitar Jad, Maalouf Hani, Ghattas Souad, Hadeer Ribal Aby, Younes Ahmad, Rahban Hind, El Rassi Ziad
Department of General Surgery Balamand University Saint Georges Hospital University Medical Center, Beirut, Lebanon.
Laboratory Department Lebanese American University Medical Center, Beirut, Lebanon.
Case Rep Surg. 2024 May 29;2024:8269752. doi: 10.1155/2024/8269752. eCollection 2024.
Multiple types of fistulas associated with the appendix have been reported; however, duodenal fistula resulting from perforated acute appendicitis has only been documented in one previous case. In this report, we present the case of an 18-year-old male patient who was diagnosed to have a complicated appendicitis in its normal position with abscess formation. He was started on IV antibiotics and underwent a CT-guided drainage of the abscess with drain placement. Two days later due to biliary output from the drain, CT fistulography and diagnostic laparoscopy were performed that revealed the presence of a duodenal fistula. The potential for duodenal fistula formation in patients with complicated appendicitis must always be taken into consideration. Consequently, it is crucial to establish an appropriate management plan aimed at preventing additional serious complications arising from duodenal perforation.
已有多种与阑尾相关的瘘管类型的报道；然而，急性阑尾炎穿孔导致十二指肠瘘仅在之前的一例病例中有记录。在本报告中，我们介绍了一名18岁男性患者的病例，该患者被诊断为正常位置的复杂性阑尾炎并伴有脓肿形成。他开始接受静脉抗生素治疗，并在CT引导下进行脓肿引流并放置引流管。两天后，由于引流管有胆汁流出，进行了CT瘘管造影和诊断性腹腔镜检查，结果显示存在十二指肠瘘。对于复杂性阑尾炎患者，必须始终考虑十二指肠瘘形成的可能性。因此，制定适当的管理计划以防止十二指肠穿孔引发更多严重并发症至关重要。
