PDF(Pubmed)
Abstract：
BACKGROUND: Appendicitis is one of the most common causes of acute abdominal pain and remains the most common abdominal-related emergency seen in emergency room that needs urgent surgery (Yang et al. in J Emerg Med 43:980-2, 2012. 10.1016/j.jemermed.2010.11.056, Wickramasinghe et al. in World J Surg 45:1999-2008, 2021. 10.1007/s00268-021-06077-5). The characteristic presentation is a vague epigastric or periumbilical discomfort or pain that migrates to the lower right quadrant in 50% of cases. Other related symptoms, such as nausea, anorexia, vomiting, and change in bowel habits, occur in varying percentages. The diagnosis is usually reached through comprehensive history, physical examination, laboratory tests, and radiological investigations as needed. Nowadays, computed tomography of the abdomen and pelvis is considered the modality of choice for definitive assessment of patients being evaluated for possible appendicitis. Anatomical variations or an ectopic appendix are rarely reported or highlighted in literature.
METHODS: Left-sided appendicitis is a rare (Hu et al. in Front Surg 2022. 10.3389/fsurg.2022.896116) and atypical presentation and has rarely been reported. The majority of these cases are associated with congenital midgut malrotation, situs inversus, or an extremely long appendix (Akbulut et al. in World J Gastroenterol 16:5598-5602, 2010. 10.3748/wjg.v16.i44.5598). This case is of significance to raise awareness regarding an anatomical variation of the appendix that might delay or mislead diagnosis of appendicitis and to confirm safety of a laparoscopic approach in dealing with a left-sided appendicitis case (Yang et al. in J Emerg Med 43:980-2, 2012. 10.1016/j.jemermed.2010.11.056). We report a case of left-sided appendicitis in a 12-year-old child managed successfully via a laparoscopic approach.
CONCLUSIONS: Appendicitis remains the most common abdominal-related emergency that needs urgent surgery (Akbulut et al. in World J Gastroenterol 16:5598-5602, 2010. 10.3748/wjg.v16.i44.5598). Left-sided appendicitis is a rare (Hu et al. in Front Surg 2022. 10.3389/fsurg.2022.896116, Hu et al. in Front Surg 9:896116, 2022. 10.3389/fsurg.2022.896116) and atypical presentation and has rarely been reported. Awareness regarding an anatomical variation of the appendix and diagnostic modalities on a computed tomography scan help avoid delay in diagnosis and management of such a rare entity (Vieira et al. in J Coloproctol 39(03):279-287, 2019. 10.1016/j.jcol.2019.04.003). A laparoscopic approach is a safe approach for management of left-sided appendicitis (Yang et al. in J Emerg Med 43:980-2, 2012. 10.1016/j.jemermed.2010.11.056, Hu et al. in Front Surg 9:896116, 2022. 10.3389/fsurg.2022.896116).
METHODS: Left-sided appendicitis is a rare (Hu et al. in Front Surg 2022. 10.3389/fsurg.2022.896116) and atypical presentation and has rarely been reported. The majority of these cases are associated with congenital midgut malrotation, situs inversus, or an extremely long appendix (Akbulut et al. in World J Gastroenterol 16:5598-5602, 2010. 10.3748/wjg.v16.i44.5598). This case is of significance to raise awareness regarding an anatomical variation of the appendix that might delay or mislead diagnosis of appendicitis and to confirm safety of a laparoscopic approach in dealing with a left-sided appendicitis case (Yang et al. in J Emerg Med 43:980-2, 2012. 10.1016/j.jemermed.2010.11.056). We report a case of left-sided appendicitis in a 12-year-old child managed successfully via a laparoscopic approach.
CONCLUSIONS: Appendicitis remains the most common abdominal-related emergency that needs urgent surgery (Akbulut et al. in World J Gastroenterol 16:5598-5602, 2010. 10.3748/wjg.v16.i44.5598). Left-sided appendicitis is a rare (Hu et al. in Front Surg 2022. 10.3389/fsurg.2022.896116, Hu et al. in Front Surg 9:896116, 2022. 10.3389/fsurg.2022.896116) and atypical presentation and has rarely been reported. Awareness regarding an anatomical variation of the appendix and diagnostic modalities on a computed tomography scan help avoid delay in diagnosis and management of such a rare entity (Vieira et al. in J Coloproctol 39(03):279-287, 2019. 10.1016/j.jcol.2019.04.003). A laparoscopic approach is a safe approach for management of left-sided appendicitis (Yang et al. in J Emerg Med 43:980-2, 2012. 10.1016/j.jemermed.2010.11.056, Hu et al. in Front Surg 9:896116, 2022. 10.3389/fsurg.2022.896116).
摘要：
背景：阑尾炎是急性腹痛的最常见原因之一，并且仍然是急诊室中需要紧急手术的最常见的腹部相关紧急情况（Yang等人。在JEmergMed43：980-2，2012。10.1016/j.jememed.2010.11.056,Wickramasingheetal.世界JSurg45：1999-2008，2021。10.1007/s00268-021-06077-5)。特征性表现是模糊的上腹部或脐周围不适或疼痛，在50％的病例中迁移到右下象限。其他相关症状,比如恶心，厌食症,呕吐,改变排便习惯,以不同的百分比发生。诊断通常是通过综合病史来实现的，体检,实验室测试,根据需要进行放射学调查。如今,腹部和骨盆的计算机断层扫描被认为是对正在评估的可能阑尾炎患者进行明确评估的首选方式.文献中很少报道或强调解剖变异或异位阑尾。
方法：左侧阑尾炎是一种罕见的（Hu等人。在前Surg2022。10.3389/fsurg.202.896116）和非典型表现，很少有报道。这些病例中的大多数与先天性中肠旋转不良有关，situsinversus,或极长的阑尾(Akbulut等人。世界胃肠病杂志16：5598-5602，2010。10.3748/wjg。V16.i44.5598)。此病例对于提高对阑尾解剖变异的认识，可能会延迟或误导阑尾炎的诊断，并确认腹腔镜方法在处理左侧阑尾炎病例中的安全性具有重要意义（Yang等人。在JEmergMed43：980-2，2012。10.1016/j.jemememed.2010.11.056）。我们报告了一例通过腹腔镜方法成功治疗的12岁儿童的左侧阑尾炎。
结论：阑尾炎仍然是最常见的腹部相关急症，需要紧急手术（Akbulut等人。世界胃肠病杂志16：5598-5602，2010。10.3748/wjg。V16.i44.5598)。左侧阑尾炎是一种罕见的(Hu等人。在前Surg2022。10.3389/fsurg.2020.896116，胡等人。在前传9：896116，2022。10.3389/fsurg.202.896116）和非典型表现，很少有报道。了解阑尾的解剖变异和计算机断层扫描的诊断方式有助于避免这种罕见实体的诊断和管理延迟（Vieira等人。在JColoproctol39（03）：279-287，2019年。10.1016/j.jcol.2019.04.003）。腹腔镜方法是治疗左侧阑尾炎的安全方法（Yang等人。在JEmergMed43：980-2，2012。10.1016/j.jemememed.2010.11.056,Huetal.在前传9：896116，2022。10.3389/fsurg.2020.896116）。
方法：左侧阑尾炎是一种罕见的（Hu等人。在前Surg2022。10.3389/fsurg.202.896116）和非典型表现，很少有报道。这些病例中的大多数与先天性中肠旋转不良有关，situsinversus,或极长的阑尾(Akbulut等人。世界胃肠病杂志16：5598-5602，2010。10.3748/wjg。V16.i44.5598)。此病例对于提高对阑尾解剖变异的认识，可能会延迟或误导阑尾炎的诊断，并确认腹腔镜方法在处理左侧阑尾炎病例中的安全性具有重要意义（Yang等人。在JEmergMed43：980-2，2012。10.1016/j.jemememed.2010.11.056）。我们报告了一例通过腹腔镜方法成功治疗的12岁儿童的左侧阑尾炎。
结论：阑尾炎仍然是最常见的腹部相关急症，需要紧急手术（Akbulut等人。世界胃肠病杂志16：5598-5602，2010。10.3748/wjg。V16.i44.5598)。左侧阑尾炎是一种罕见的(Hu等人。在前Surg2022。10.3389/fsurg.2020.896116，胡等人。在前传9：896116，2022。10.3389/fsurg.202.896116）和非典型表现，很少有报道。了解阑尾的解剖变异和计算机断层扫描的诊断方式有助于避免这种罕见实体的诊断和管理延迟（Vieira等人。在JColoproctol39（03）：279-287，2019年。10.1016/j.jcol.2019.04.003）。腹腔镜方法是治疗左侧阑尾炎的安全方法（Yang等人。在JEmergMed43：980-2，2012。10.1016/j.jemememed.2010.11.056,Huetal.在前传9：896116，2022。10.3389/fsurg.2020.896116）。
