Bezabih Natnael Alemu, Mehammed Abdudin Heru, Gebresilassie Muluken Yifru, Damtie Misganaw Yigletie, Bezabih Bezawit Alemu
Addis Ababa University, College of Health Sciences, Department of Radiology, Addis Ababa, Ethiopia.
Saint Paul's Hospital Millennium Medical College, Department of Radiology, Addis Ababa, Ethiopia.
Radiol Case Rep. 2024 Aug 3;19(10):4513-4516. doi: 10.1016/j.radcr.2024.07.049. eCollection 2024 Oct.
Intestinal nonrotation is the most common type of mid-gut anomaly where the small bowel predominantly occupies the right side of the peritoneal cavity, while the colon primarily resides on the left. The occurrence of acute appendicitis in mid-gut anomalies poses a serious diagnostic challenge due to unprecedented clinical and imaging features. Here we present a 20-year-old female who came to the hospital with left lower abdominal pain of 3 weeks duration, referred with a diagnosis of tubo-ovarian abscess. Further evaluation with an abdominopelvic CT scan revealed ileocecal junction in the left lower quadrant with a well-defined appendiceal abscess. The absence of a prior diagnosis of nonrotation, combined with the atypical presentation of pain, complicates the diagnosis of appendicitis. We emphasize the significance of considering left-sided appendicitis as a potential diagnosis for left-sided abdominal pain and recommend early cross-sectional imaging to prevent complications and improve surgical outcomes.
肠旋转不良是中肠异常最常见的类型，其中小肠主要占据腹腔右侧，而结肠主要位于左侧。由于前所未有的临床和影像学特征，中肠异常中急性阑尾炎的发生带来了严重的诊断挑战。在此，我们报告一名20岁女性，因持续3周的左下腹痛入院，初诊为输卵管卵巢脓肿。经腹盆腔CT扫描进一步评估发现，回盲部位于左下腹，伴有明确的阑尾脓肿。由于之前未诊断出旋转不良，加上疼痛表现不典型，阑尾炎的诊断变得复杂。我们强调，对于左侧腹痛，应考虑左侧阑尾炎作为潜在诊断的重要性，并建议早期进行横断面成像，以预防并发症并改善手术效果。
