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慢性阑尾炎:慢性腹痛被忽视的病因:病例报告

Chronic appendicitis; the overlooked cause of chronic abdominal pain: Case report.

作者信息

Assefa Eskinder Amare, Shumiye Yonas Girma, Tesfaye Abel Shiferaw, Alemu Anatia Kifle, Ayalew Zekarias Seifu

机构信息

Yehuleshet Medical and Surgical Center, Department of Surgery, PO BOX: 13682, Addis Ababa, Ethiopia.

Yehuleshet Medical and Surgical Center, Department of Surgery, PO BOX: 13682, Addis Ababa, Ethiopia; Addis Ababa University, College of Health Sciences, School of Medicine Department of Pathology.

出版信息

Int J Surg Case Rep. 2024 Dec;125:110593. doi: 10.1016/j.ijscr.2024.110593. Epub 2024 Nov 12.

DOI:10.1016/j.ijscr.2024.110593
PMID:39579627
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11621492/
Abstract

INTRODUCTION

Acute appendicitis is a surgical emergency and the diagnosis is straightforward in majority of the cases. However, chronic appendicitis, a relatively rare cause of chronic abdominal pain, presents a unique challenge due to its atypical presentation. This rarity underscores the need for vigilance and thoroughness in our practice to avoid misdiagnosis or delay in diagnosis.

CASE PRESENTATION

We present a case of chronic appendicitis in which a 30-year-old male patient presented with a nine-month history of chronic abdominal pain with mild right lower quadrant tenderness. Abdominal ultrasound suggested a feature of appendicitis, and the patient underwent appendectomy; finally, the diagnosis was confirmed on the histopathologic exam.

DISCUSSION

Chronic appendicitis, a relatively rare condition, is often diagnosed late due to a lack of well-developed diagnostic criteria and atypical presentation. However, using abdominal U/S and CT scan imaging plays a crucial role in assessing chronic appendicitis, highlighting the importance of these tools in our practice. In many cases, the ultimate diagnosis is confirmed after a histopathology exam, reinforcing the need for a comprehensive approach to diagnosis.

CONCLUSION

Chronic appendicitis can have an atypical presentation with milder symptoms, and it should be considered in the differential diagnosis of patients presenting with chronic right lower quadrant abdominal pain. Abdominal U/S is an important imaging modality in assessing suspect cases of chronic appendicitis.

摘要

引言

急性阑尾炎是一种外科急症,大多数情况下诊断较为直接。然而,慢性阑尾炎作为慢性腹痛相对少见的病因,因其不典型的表现带来了独特的挑战。这种少见性凸显了我们在临床实践中保持警惕和全面检查以避免误诊或诊断延误的必要性。

病例介绍

我们呈现一例慢性阑尾炎病例,一名30岁男性患者有9个月慢性腹痛病史,右下腹轻度压痛。腹部超声提示阑尾炎特征,患者接受了阑尾切除术;最终,组织病理学检查确诊。

讨论

慢性阑尾炎相对少见,由于缺乏完善的诊断标准和不典型表现,常诊断较晚。然而,腹部超声和CT扫描成像在评估慢性阑尾炎中起着关键作用,凸显了这些工具在我们临床实践中的重要性。在许多病例中,最终诊断在组织病理学检查后得以证实,这强化了采用综合诊断方法的必要性。

结论

慢性阑尾炎可表现为症状较轻的不典型症状,在慢性右下腹腹痛患者的鉴别诊断中应予以考虑。腹部超声是评估可疑慢性阑尾炎病例的重要影像学检查手段。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6262/11621492/6848a0d2f382/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6262/11621492/7231ec3682f2/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6262/11621492/23fa4f3f2ca8/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6262/11621492/6848a0d2f382/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6262/11621492/7231ec3682f2/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6262/11621492/23fa4f3f2ca8/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6262/11621492/6848a0d2f382/gr3.jpg

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