[急性左侧阑尾炎：体层密度测定法的诊断作用]
[Acute left-side appendicitis: diagnostic contribution of tomodensitometry].
作者信息
Nisolle J F, Bodart E, de Canière L, Bahati M, Michel L, Trigaux J P
机构信息
Service de radiologie, cliniques UCL de Mont-Godinne, Yvoir, Belgique.
出版信息
Arch Pediatr. 1996 Jan;3(1):47-50. doi: 10.1016/s0929-693x(96)80009-1.
BACKGROUND
Some cases of left-sided appendicitis related to malrotation or situs inversus have been reported. Another type of left-sided appendicitis is reported.
CASE REPORT
A 9 year-old boy was admitted suffering from a 2-day history of severe left-sided abdominal pain of the lower quadrant with fever at 38 degrees C. He presented abdominal tenderness and guarding, maximal in the left lower quadrant. His leukocyte count was 22,000/mm3. Ultrasonography showed a digestive tubular structure with thick walls in the left lower quadrant. CT scan revealed a dilated right-sided appendix with localized perforation, whose extremity was located in the left lower quadrant along the lateral wall. The diagnosis was confirmed by median laparotomy.
CONCLUSION
Left-sided appendicitis can also be related to a dilated right appendix with its extremity in the left lower-quadrant near the lateral wall. CT scan can then be helpful for diagnosis when ultrasonography remains unconclusive.
背景
已有一些与肠旋转不良或内脏反位相关的左侧阑尾炎病例报道。现报道另一类型的左侧阑尾炎。
病例报告
一名9岁男孩因左下腹严重腹痛2天、发热至38摄氏度入院。他有腹部压痛及肌紧张，以左下腹最为明显。其白细胞计数为22,000/mm³。超声检查显示左下腹有一个壁增厚的消化管状结构。CT扫描显示右侧阑尾扩张并局部穿孔，阑尾末端沿外侧壁位于左下腹。经正中剖腹探查确诊。
结论
左侧阑尾炎也可能与右侧阑尾扩张且末端位于左下腹外侧壁附近有关。当超声检查结果不明确时，CT扫描有助于诊断。
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