Manasra Mahmoud R, Alhroob Thaer, Marrawani Mohammad, Batanje Dalia, Imran Yahya, Harahsha Moatz, Amleh Abdul-Karim, Zugayar Diaa
Palestine Polytechnic University College of Medicine and Health Science, PO Box 198, Hebron, Palestine.
Neonatal Intensive Care Unit (NICU), H-Clinic Specialty Hospital, PO Box 108, Ramallah, Palestine.
J Surg Case Rep. 2024 Jul 29;2024(7):rjae471. doi: 10.1093/jscr/rjae471. eCollection 2024 Jul.
Necrotizing enterocolitis (NEC) predominantly affects preterm infants and can mimic other conditions like acute appendicitis. Neonatal appendicitis (NA) is extremely rare, with an incidence of 0.04-0.2% and high fatality rates. Due to its rarity and resemblance to other neonatal conditions, NA diagnosis is often delayed. We report a case of a 2220-g male preterm neonate delivered at 31 + 5 weeks via urgent cesarean section due to chorioamnionitis, initially misdiagnosed with NEC but later found to have a perforated appendix. The neonate recovered well post-surgery, with the ileostomy reversed 10 weeks later. Prompt surgical intervention is crucial for NA, as it requires different management than NEC. This case underscores the importance of considering NA in preterm infants with severe abdominal symptoms and emphasizes timely surgical intervention to improve outcomes. Additionally, it supports the hypothesis that localized NEC involving the appendix may have a better prognosis than generalized NEC.
坏死性小肠结肠炎（NEC）主要影响早产儿，且可能类似于其他病症，如急性阑尾炎。新生儿阑尾炎（NA）极为罕见，发病率为0.04 - 0.2%，病死率高。由于其罕见性以及与其他新生儿病症相似，NA的诊断常常延迟。我们报告一例病例，一名2220克的男性早产儿，因绒毛膜羊膜炎于31 + 5周时通过紧急剖宫产出生，最初被误诊为NEC，但后来发现患有阑尾穿孔。该新生儿术后恢复良好，10周后回纳了回肠造口术。对于NA，及时的手术干预至关重要，因为它需要与NEC不同的治疗方法。本病例强调了在有严重腹部症状的早产儿中考虑NA的重要性，并强调及时进行手术干预以改善预后。此外，它支持这样一种假设，即累及阑尾的局限性NEC可能比全身性NEC预后更好。
