Internal Medicine Department, College of Medicine, Prince Sattam Bin Abdulaziz University, P.O. Box 173, 11942, Al-Kharj, Saudi Arabia.
J Med Case Rep. 2024 Oct 27;18(1):507. doi: 10.1186/s13256-024-04847-y.
Unlike acute appendicitis, chronic appendicitis is characterized by nonspecific abdominal pain and intermittent course. This may lead to late diagnosis or misdiagnosis, with the possibility of serious complications.
A male patient of Arab origin aged 55 years had a 2-year history of recurrent episodes of mild pain in the right lower quadrant of the abdomen. The episodes were associated with nausea, chills, and abdominal bloating but no vomiting, rectal bleeding, or weight loss. On examination, the patient showed soft and lax abdomen with mild tenderness in the right lower quadrant, with no organomegaly or abdominal masses. Laboratory findings showed normal complete blood count and C-reactive protein. The patient underwent colonoscopy to rule out malignancy, which showed appendiceal orifice polyp that required resection. The computed tomography scan showed an enlarged appendix with multiple intraluminal dense appendicoliths. The largest stone at the appendiceal orifice measured 1.5 cm × 0.9 cm and was partially protruding within the cecal lumen. The diagnosis of chronic appendicitis was confirmed. The patient underwent appendectomy and was asymptomatic a few days after discharge.
We are reporting a patient with chronic appendicitis presented with multiple appendicoliths. The patient was initially misdiagnosed as periappendiceal orifice polyp. The current finding highlights the importance of imaging, especially computed tomography in confirming the diagnosis in patients with atypical appendicitis presentation.
与急性阑尾炎不同，慢性阑尾炎的特点是腹痛不典型且呈间歇性发作。这可能导致诊断延迟或误诊，进而出现严重并发症。
一位 55 岁的阿拉伯裔男性患者，有 2 年反复发作右下腹痛的病史。每次发作均伴有恶心、寒战和腹胀，但无呕吐、直肠出血或体重减轻。体格检查显示腹部柔软、松弛，右下腹有轻度压痛，无肝脾肿大或腹部肿块。实验室检查发现全血细胞计数和 C 反应蛋白正常。患者行结肠镜检查以排除恶性肿瘤，结果显示阑尾口息肉，需要切除。计算机断层扫描显示阑尾肿大，腔内有多个致密的阑尾结石。阑尾口最大的结石大小为 1.5cm×0.9cm，部分突入盲肠腔内。诊断为慢性阑尾炎。患者行阑尾切除术，出院后几天无症状。
我们报告了一例以多发性阑尾结石为表现的慢性阑尾炎患者。该患者最初被误诊为阑尾口息肉。目前的发现强调了影像学检查的重要性，特别是在不典型阑尾炎患者中，CT 有助于明确诊断。
