Zhang Yongtai, Xiong Hongli, Cheng Fang, Wang Qi, Li Jianbo
Department of Forensic Medicine, Faculty of Basic Medical Sciences, Chongqing Medical University, Chongqing, 400016, China.
Forensic Sci Med Pathol. 2025 Mar;21(1):255-259. doi: 10.1007/s12024-024-00841-4. Epub 2024 Jul 13.
Acute appendicitis is one of the most common acute abdominal issues requiring surgery and is usually treated by appendectomy. During the process of removing the appendix, the appendiceal artery is severed. In most individuals, the appendix is supplied by only one appendiceal artery.
A 50-year-old man underwent appendectomy. During the surgical procedure, the appendix artery and two accessory arteries of the appendix were severed, leading to massive hemorrhaging in the abdominal cavity, which ultimately resulted in the patient's unfortunate demise.
Through this case, we hope that surgeons can learn more about the anatomy of the appendiceal artery and understand the possibility of accessory arteries to the appendix. During surgery, the blood vessels supplying the appendix should be carefully explored, and the "one-size-fits-all approach" should be avoided. Moreover, attention should be given to complications after appendectomy, and timely symptomatic treatment should be provided. Key points 1. Rare typing: The case of death due to improper handling of the accessory appendicular artery during appendectomy in patients with three appendiceal arteries is currently unreported. 2. Detailed anatomical knowledge: Surgeons performing an appendectomy need to make a detailed exploration of the blood vessel supply of the appendix to avoid ignoring anatomically different blood vessels. 3. Avoid a one-size-fits-all approach: In the surgical process, a "one-size-fits-all" approach should be avoided, that is, the same surgical approach should not be used in all cases, but should be adjusted according to the anatomical characteristics of the individual. 4. Observation of postoperative bleeding: In the perioperative period, peritoneal drainage should be closely observed. If a large amount of bloody fluid is found, timely surgical treatment should be carried out. 5. Attention to complications: Surgeons should pay.
急性阑尾炎是最常见的需要手术治疗的急腹症之一，通常通过阑尾切除术进行治疗。在切除阑尾的过程中，阑尾动脉会被切断。在大多数个体中，阑尾仅由一条阑尾动脉供血。
一名50岁男性接受了阑尾切除术。在手术过程中，阑尾动脉和两条阑尾副动脉被切断，导致腹腔大量出血，最终导致患者不幸死亡。
通过这个病例，我们希望外科医生能够更多地了解阑尾动脉的解剖结构，并了解阑尾存在副动脉的可能性。在手术过程中，应仔细探查供应阑尾的血管，避免采用“一刀切”的方法。此外，应关注阑尾切除术后的并发症，并及时进行对症治疗。要点1.罕见类型：阑尾有三条动脉的患者在阑尾切除术中因阑尾副动脉处理不当导致死亡的病例目前未见报道。2.详细的解剖学知识：进行阑尾切除术的外科医生需要对阑尾的血管供应进行详细探查，以避免忽略解剖结构不同的血管。3.避免一刀切的方法：在手术过程中，应避免采用“一刀切”的方法，即不应在所有病例中使用相同的手术方法，而应根据个体的解剖特征进行调整。4.观察术后出血：在围手术期，应密切观察腹腔引流情况。如果发现大量血性液体，应及时进行手术治疗。5.关注并发症：外科医生应予以关注。
