PDF(Pubmed)
Abstract：
Appendicitis is the most common cause of acute abdominal pain requiring surgical intervention; however, it is extremely rare in infants. Its diagnosis and treatment are challenging due to nonspecific clinical signs and symptoms. As a result, delayed or missed diagnosis is common in young children and is associated with an increased risk of perforation and peritonitis. We reported a case of a 4-month-old healthy male child. The patient presented with abdominal distention and fever. After ruling out other possible causes, he was diagnosed with acute appendicitis, which was confirmed by a CT scan. A gangrenous appendix, dilated bowel loops, and free fluid in the abdomen were discovered during surgery. An appendectomy was performed. The appendix in infants has an average length of 4.5 cm compared with 9.5 cm in adults. Infantile appendicitis is considered rare but cases have been documented also in neonates, misdiagnosis rates are high due to rarity in this age group in addition to nonspecific signs and symptoms, which led to a high perforation rate. Ultrasonography can diagnose appendicitis in children with a sensitivity and specificity of 90%-95% without subjecting the child to radiation. A physician should always keep the diagnosis of appendicitis in mind in the infant age group, even though it is rare, as a delay in diagnosis and treatment has been associated with an increased risk of complications including appendicular perforation and peritonitis.
摘要：
阑尾炎是需要手术干预的急性腹痛的最常见原因；然而，在婴儿中极为罕见。由于非特异性临床体征和症状，其诊断和治疗具有挑战性。因此,延迟或漏诊在幼儿中很常见,并且与穿孔和腹膜炎的风险增加相关.我们报告了一例4个月大的健康男童。患者出现腹胀和发热。排除了其他可能的原因后,他被诊断出患有急性阑尾炎,CT扫描证实了这一点。坏疽阑尾,扩张的肠loop,在手术过程中发现了腹部的游离液体。进行阑尾切除术。婴儿的阑尾平均长度为4.5厘米，而成人为9.5厘米。婴儿阑尾炎被认为是罕见的，但在新生儿中也有病例记录。除了非特异性体征和症状外，由于该年龄组的罕见性，误诊率很高，这导致了高穿孔率。超声检查可以诊断儿童阑尾炎，其敏感性和特异性为90％-95％，而无需对儿童进行辐射。在婴儿年龄组，医生应始终牢记阑尾炎的诊断，尽管很罕见,由于诊断和治疗的延迟与包括阑尾穿孔和腹膜炎在内的并发症风险增加有关.
