PDF(Pubmed)
Abstract：
In clinical practice, the typical approach to ingested foreign bodies in stable patients involves expectant management, as most materials pass through the gastrointestinal (GI) tract without adverse effects. However, foreign bodies that travel through the appendix\'s lumen can cause acute appendicitis due to their inability to exit the colon. Rarer causes of appendicitis include parasitic infiltration by Ascaris lumbricoides. The wandering behavior of Ascaris lumbricoides within the GI tract can lead to various surgical complications in the abdomen. Occasionally, these parasites can migrate to the vermiform appendix, where they may either induce pathological changes or remain asymptomatic. We report an unusual case of an eight-year-old Pakistani female patient who presented to the emergency room with pain in the right iliac fossa, associated with anorexia and nausea, for one day. On examination, the patient was found to be vitally stable, with right iliac fossa tenderness noted on palpation. Additionally, the patient exhibited positive pointing, rebound, Rovsing, and psoas signs. Her medical history revealed that she had ingested a metallic needle seven months ago. Blood tests were undertaken, and an abdominal X-ray confirmed the existence of a radiopaque metallic object in the right lower quadrant of the abdomen. The patient underwent an open appendicectomy for acute appendicitis and was discovered to have a metallic needle lodged in the vermiform appendix. Concurrently, she also had ascariasis, as she vomited a 23-cm-long Ascaris lumbricoides worm. It is important to consider both mechanical and parasitic etiologies in diagnosing acute appendicitis; detailed evaluation and management strategies are necessary to address these unique etiologies effectively.
摘要：
在临床实践中,在稳定患者中摄入异物的典型方法包括期待管理，因为大多数材料通过胃肠道（GI）而没有副作用。然而,通过阑尾腔的异物由于无法离开结肠而引起急性阑尾炎。较少引起阑尾炎的原因包括蛔虫的寄生虫浸润。A虫在胃肠道内的游走行为可导致腹部各种手术并发症。偶尔,这些寄生虫可以迁移到阑尾，它们可能诱发病理变化或保持无症状。我们报告了一个不寻常的病例，一个8岁的巴基斯坦女性患者，她出现在急诊室，右髂窝疼痛，与厌食症和恶心有关，有一天。在检查中，患者被发现非常稳定，触诊时可见右髂窝压痛。此外,患者表现出积极的指向，回弹,Rossing,和腰大肌的标志。她的病史显示她七个月前摄入了一根金属针。进行了血液检查，腹部X光检查证实在腹部右下象限存在不透射线的金属物体。该患者因急性阑尾炎接受了开放性阑尾切除术，并被发现在阑尾中装有金属针。同时,她也有蛔虫病,她吐了一条23厘米长的蛔虫蠕虫。在诊断急性阑尾炎时，必须同时考虑机械性和寄生性病因；需要详细的评估和管理策略来有效地解决这些独特的病因。
