METHODS: A case of 18 year female with complaints of right iliac fossa pain and vomiting was diagnosed clinically as acute appendicitis and underwent emergency open appendectomy where a cecal perforation was encountered intra-operatively for which a Modified Graham\'s Patch Repair was done.
UNASSIGNED: Acute appendicitis can sometimes present with complications like perforation, among which cecal perforation is rare and difficult to diagnose in the initial setting. Perforated appendicitis or colon can increase morbidity and mortality significantly. High degree of suspicion and early surgical approach can lead to identification of rare complications, which can still pose a surgical dilemma on the approach of management.
CONCLUSIONS: Cecal perforation in suspected acute appendicitis is a rarely encountered intra operative complication. Management approaches can range from less invasive suture with omental patch repair to more invasive right hemicolectomy.
方法:一名18岁女性患者,主诉右髂窝疼痛和呕吐,临床诊断为急性阑尾炎,并接受了紧急开放阑尾切除术,其中在手术中遇到盲肠穿孔,并进行了改良Graham的修补。
■急性阑尾炎有时会出现穿孔等并发症,其中盲肠穿孔是罕见的,在初始设置难以诊断。穿孔性阑尾炎或结肠可显著增加发病率和死亡率。高度怀疑和早期手术方法可导致罕见并发症的识别,这仍然会给管理方法带来外科困境。
结论:疑似急性阑尾炎的盲肠穿孔是一种罕见的术中并发症。管理方法可以从侵入性较小的缝合和网膜补片修复到更侵入性的右半结肠切除术。