Jaramillo Juan D, Mosquera Brayan R, Botello Yensy P
Surgery, Clínica Colombia, Santiago de Cali, COL.
Cureus. 2024 Jun 6;16(6):e61839. doi: 10.7759/cureus.61839. eCollection 2024 Jun.
Appendicitis, characterized by inflammation and obstruction of the appendiceal lumen, is a common surgical emergency often attributed to various factors. We present the case of an 18-year-old female who developed retrocecal appendicitis following blunt abdominal trauma, a rare occurrence with significant diagnostic challenges. Initial symptoms mimicked upper abdominal trauma, evolving to classic signs of appendicitis within hours. Despite a negative pre-trauma history of abdominal pain, clinical evaluation led to a suspicion of appendicitis. Contrast-enhanced CT scan confirmed the thickening of the cecal appendix, prompting urgent surgical intervention. An open appendectomy revealed a congested retrocecal appendix, supporting the diagnosis. Our case underscores the importance of considering trauma as a potential trigger for appendicitis, especially in the absence of typical pre-trauma symptoms. Diagnostic criteria for post-trauma appendicitis are evolving, and we underscore a comprehensive clinical assessment alongside imaging modalities. While surgical management remains standard, newer approaches like endoscopic retrograde appendicitis therapy warrant exploration. Further research is essential to refine diagnostic and therapeutic strategies for this uncommon presentation, ensuring timely intervention and improved patient outcomes.
阑尾炎以阑尾腔的炎症和梗阻为特征，是一种常见的外科急症，通常由多种因素引起。我们报告一例18岁女性病例，该患者在腹部钝性创伤后发生盲肠后位阑尾炎，这种情况罕见且诊断颇具挑战。初始症状类似上腹部创伤，数小时内演变为典型的阑尾炎体征。尽管创伤前无腹痛病史，但临床评估仍怀疑为阑尾炎。增强CT扫描证实盲肠阑尾增厚，促使紧急进行手术干预。开放性阑尾切除术显示盲肠后位阑尾充血，支持诊断。我们的病例强调了将创伤视为阑尾炎潜在触发因素的重要性，尤其是在缺乏典型创伤前症状的情况下。创伤后阑尾炎的诊断标准正在不断演变，我们强调除了影像学检查外还需进行全面的临床评估。虽然手术治疗仍然是标准方法，但像内镜逆行阑尾炎治疗等新方法值得探索。进一步的研究对于完善这种不常见表现的诊断和治疗策略至关重要，以确保及时干预并改善患者预后。
