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内镜逆行阑尾炎治疗术后支架嵌顿导致阑尾炎加重:一例报告

Post-endoscopic retrograde appendicitis therapy stent impaction leading to exacerbation of appendicitis: A case report.

作者信息

Ma Tan-Tu, Lyu Hao-Run

机构信息

Department of Hepatobiliary Surgery, Peking University People's Hospital, Peking University, Beijing 100044, China.

Department of Emergency Surgery, Peking University People's Hospital, Beijing 100044, China.

出版信息

World J Clin Cases. 2025 Sep 6;13(25):106587. doi: 10.12998/wjcc.v13.i25.106587.

Abstract

BACKGROUND

Endoscopic retrograde appendicitis therapy (ERAT) is an emerging technique. However, its efficacy remains uncertain, and postoperative complications often exacerbate inflammation, thereby increasing the difficulty of surgery. The use of ERAT in appendicitis remains contentious, prompting the presentation of this case report.

CASE SUMMARY

We report the case of a 43-year-old female patient presenting with intermittent right lower abdominal pain for one day. The patient had undergone ERAT six months previously. Examination revealed stent impaction in the appendix, leading to exacerbated inflammation. Subsequently, a solo single-incision laparoscopic appendectomy (SSLA) was performed. The ERAT-related complications increased surgical difficulty and prolonged the operation time. Post-SSLA, the patient was hospitalized for one day and showed favorable recovery upon follow-up.

CONCLUSION

This case highlights the risks of ERAT. Thorough preoperative assessment, proper stent placement during surgery and regular postoperative follow-up are crucial in preventing complications, as their occurrence can increase surgical difficulty. Compared to ERAT, SSLA remains more widely used in clinical practice. Both techniques require further clinical data and research to optimize their application.

摘要

背景

内镜逆行性阑尾炎治疗术(ERAT)是一项新兴技术。然而,其疗效仍不确定,且术后并发症常加剧炎症,从而增加手术难度。ERAT在阑尾炎治疗中的应用仍存在争议,因此呈现本病例报告。

病例摘要

我们报告一例43岁女性患者,因间歇性右下腹痛1天就诊。该患者6个月前接受了ERAT治疗。检查发现阑尾内支架嵌顿,导致炎症加剧。随后,实施了单孔单切口腹腔镜阑尾切除术(SSLA)。ERAT相关并发症增加了手术难度并延长了手术时间。SSLA术后,患者住院1天,随访时恢复良好。

结论

本病例突出了ERAT的风险。术前进行全面评估、术中正确放置支架以及术后定期随访对于预防并发症至关重要,因为并发症的发生会增加手术难度。与ERAT相比,SSLA在临床实践中应用更为广泛。两种技术都需要更多临床数据和研究以优化其应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/554d/12243855/e1026a6a7dc1/wjcc-13-25-106587-g001.jpg

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