acute appendicitis

急性阑尾炎
  • 文章类型: Case Reports
    Situs倒置,一种不常见的疾病,导致不对称器官的方向与正常解剖结构相反。它可以是局部的,只影响胸腔或腹腔,或满,涉及胸部和腹部器官的移位。一名31岁的埃塞俄比亚男性患者在左下腹出现3天的偏头痛。伴随着疼痛,他出现了恶心的症状,摄入物质的呕吐,和食欲不振。调查与左侧阑尾炎伴全位倒位一致。因此,患者手术出院,无围手术期并发症。阑尾炎是左下腹疼痛的罕见原因。为了减少患者治疗的延误和可避免的围手术期并发症,急诊医生,放射科医生,外科医生必须对反位和左侧阑尾炎有更多的了解。
    Situs inversus, an uncommon disorder, causes the orientation of asymmetric organs to be opposite to that of normal anatomy. It can be either partial, affecting only the thoracic or abdominal cavities, or full, involving the transposition of both the thoracic and abdominal organs. A 31-year-old Ethiopian male patient presented with migratory abdominal pain in the left lower quadrant for 3 days. Associated with the pain, he experienced symptoms of nausea, vomiting of ingested matter, and loss of appetite. Investigations were consistent with left-sided appendicitis with situs inversus totalis. Therefore, the patient was operated on and discharged with no perioperative complications. Appendicitis is a rare cause of left lower quadrant pain. In order to reduce the delay in patient treatment and avoidable perioperative complications, emergency physicians, radiologists, and surgeons must become more knowledgeable about situs inversus and left side appendicitis.
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  • 文章类型: Case Reports
    脊椎盘炎是一种具有重要医学和社会经济意义的多因素疾病,其治疗对临床医生和外科医生提出了挑战。急性阑尾炎是儿童常见的炎症性疾病,术后并发症发生在55%的病例中。我们介绍了一名15岁男性在穿孔性阑尾炎手术后两个月出现严重背痛和发烧症状的病例。计算机断层扫描(CT)显示T12-L1脊柱水平的脊椎盘炎。进行了椎间盘切除术和后路椎弓根螺钉固定,随后的抗生素治疗导致术前症状的缓解.据我们所知,这是文献中第3例急性阑尾炎穿孔后的脊椎盘炎。及时诊断和治疗脊椎盘炎是降低这些患者永久性神经功能缺损率的先决条件。
    Spondylodiscitis is a multifactorial disease of significant medical and socioeconomic importance, the treatment of which presents a challenge to clinicians and surgeons. Acute appendicitis is a common inflammatory disease in children, with postoperative complications occurring in up to 55% of cases. We present the case of a 15-year-old male with symptoms of severe back pain and fever two months following surgery for perforated appendicitis. The computed tomography (CT) revealed spondylodiscitis of T12-L1 spinal level. Discectomy and posterior pedicle-screw fixation were performed, followed by antibiotic treatment resulted in the resolution of preoperative symptoms. To the best of our knowledge, this is the third case of spondylodiscitis after perforated acute appendicitis in literature. Timely diagnosis and treatment in cases of spondylodiscitis are prerequisites for lowering the rate of permanent neurological deficits in these patients.
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  • 文章类型: Case Reports
    急性阑尾炎是全球急腹症的常见原因。与之相关的并发症有时可能是不可预测的,并且在此类并发症的管理中面临困境。
    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。
    UNASSIGNED: Acute appendicitis is a common cause of acute abdomen worldwide. The complications associated with it can sometimes be unpredictable and pose a dilemma in the management of such complications.
    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.
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  • 文章类型: Journal Article
    背景:急性阑尾炎是需要手术的最常见的急性腹部疾病之一,通常通过阑尾切除术治疗。在删除附录的过程中,阑尾动脉被切断.在大多数个人中,阑尾仅由一条阑尾动脉供应。
    方法:一名50岁男子接受了阑尾切除术。在手术过程中,阑尾动脉和阑尾的两个副动脉被切断,导致腹腔大量出血,这最终导致了病人不幸的死亡。
    结论:通过这个案例,我们希望外科医生能够更多地了解阑尾动脉的解剖结构,了解阑尾副动脉的可能性。手术期间,供应阑尾的血管应该仔细探索,应该避免“一刀切”的做法。此外,应注意阑尾切除术后的并发症,并及时对症治疗。关键点1.罕见分型:目前未报道有三条阑尾动脉患者在阑尾切除术中因副阑尾动脉处理不当而死亡的病例。2.详细的解剖学知识:进行阑尾切除术的外科医生需要对阑尾的血管供应进行详细的探索,以避免忽略解剖学上不同的血管。3.避免一刀切的方法:在手术过程中,应避免“一刀切”的做法,也就是说,不应该在所有情况下都使用相同的手术方法,但应根据个体的解剖特征进行调整。4.术后出血的观察:围手术期,应密切观察腹腔引流。如果发现大量的血液,应及时进行手术治疗。5.注意并发症:外科医生应该付费。
    BACKGROUND: Acute appendicitis is one of the most common acute abdominal issues requiring surgery and is usually treated by appendectomy. During the process of removing the appendix, the appendiceal artery is severed. In most individuals, the appendix is supplied by only one appendiceal artery.
    METHODS: A 50-year-old man underwent appendectomy. During the surgical procedure, the appendix artery and two accessory arteries of the appendix were severed, leading to massive hemorrhaging in the abdominal cavity, which ultimately resulted in the patient\'s unfortunate demise.
    CONCLUSIONS: Through this case, we hope that surgeons can learn more about the anatomy of the appendiceal artery and understand the possibility of accessory arteries to the appendix. During surgery, the blood vessels supplying the appendix should be carefully explored, and the \"one-size-fits-all approach\" should be avoided. Moreover, attention should be given to complications after appendectomy, and timely symptomatic treatment should be provided. Key points 1. Rare typing: The case of death due to improper handling of the accessory appendicular artery during appendectomy in patients with three appendiceal arteries is currently unreported. 2. Detailed anatomical knowledge: Surgeons performing an appendectomy need to make a detailed exploration of the blood vessel supply of the appendix to avoid ignoring anatomically different blood vessels. 3. Avoid a one-size-fits-all approach: In the surgical process, a \"one-size-fits-all\" approach should be avoided, that is, the same surgical approach should not be used in all cases, but should be adjusted according to the anatomical characteristics of the individual. 4. Observation of postoperative bleeding: In the perioperative period, peritoneal drainage should be closely observed. If a large amount of bloody fluid is found, timely surgical treatment should be carried out. 5. Attention to complications: Surgeons should pay.
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  • 文章类型: Case Reports
    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.
    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.
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  • 文章类型: Case Reports
    传染性单核细胞增多症(IM)是由爱泼斯坦-巴尔病毒引起的病毒性疾病,通常表现为咽炎,淋巴结病,和疲劳。在极少数情况下,IM可引起急性阑尾炎。我们介绍了一名18岁女性的病例,她到达急诊科时腹痛加剧,咳嗽持续。最初的成像显示阑尾扩张可疑,随访检查显示颈部淋巴结肿大。她后来因严重的腹痛回到急诊室,急性阑尾炎的临床症状,和一个阳性的单点测试,导致了阑尾切除术.此病例说明急性阑尾炎患者需要进行完整的病史记录和彻底的体格检查,因为他们的病情可能是由于非典型的根本原因。
    Infectious mononucleosis (IM) is a viral illness caused by the Epstein-Barr virus that typically manifests with pharyngitis, lymphadenopathy, and fatigue. In rare cases, IM can cause acute appendicitis. We present the case of an 18-year-old female who arrived at the emergency department with worsening abdominal pain and an ongoing cough. Initial imaging showed a questionably dilated appendix, and a follow-up examination revealed cervical lymphadenopathy. She later returned to the ED with severe abdominal pain, clinical signs of acute appendicitis, and a positive monospot test, which led to an appendectomy. This case illustrates the need for complete history taking and thorough physical examination in patients with acute appendicitis, as their condition may be due to an atypical underlying cause.
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  • 文章类型: Case Reports
    急性阑尾炎是妊娠期剖腹探查术最常见的非产科原因。该病例报告涉及一名primigravida患者,由于弥漫性腹痛,在妊娠15周时到Trikala总医院急诊科就诊。主要在上腹部区域。她还报告了水汪汪的排便。持续的不典型临床症状,随着炎症标志物的升高,强烈提示诊断为急性阑尾炎。立即进行剖腹探查术,在此期间发现阑尾的急性局部炎症,导致阑尾切除术.组织学检查证实诊断为急性阑尾炎。患者在手术后立即报告疼痛缓解。术后第四天,她已出院,没有任何妊娠中期流产的迹象。在妊娠39周时,由于臀位,她通过选择性剖宫产分娩。本文讨论了该病例,并强调了妊娠期急性阑尾炎早期诊断和治疗的重大挑战,强调预防母亲和胎儿可能危及生命的并发症的重要性。
    Acute appendicitis is the most common non-obstetric reason for exploratory laparotomy during pregnancy. This case report involves a primigravida patient who presented to the emergency department of the General Hospital of Trikala at 15 weeks of gestation due to diffuse abdominal pain, primarily in the epigastric region. She also reported watery bowel movements. The ongoing atypical clinical symptoms, along with elevated inflammatory markers, strongly indicated a diagnosis of acute appendicitis. An immediate exploratory laparotomy was performed, during which acute localized inflammation of the appendix was found, leading to an appendectomy. Histological examination confirmed the diagnosis of acute appendicitis. The patient reported pain relief immediately after the surgery. On the fourth postoperative day, she was discharged without any signs of a threatened second-trimester miscarriage. At 39 gestational weeks, she delivered by elective cesarean section due to breech presentation. This paper discusses the case and highlights the significant challenges in the early diagnosis and management of acute appendicitis during pregnancy, emphasizing the importance of preventing potentially life-threatening complications for both the mother and the fetus.
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  • 文章类型: Case Reports
    背景:血吸虫病是许多发展中国家的地方性寄生虫病之一。尽管如此,即使在某些流行地区,血吸虫病继发的阑尾炎也是一种罕见的疾病。血吸虫阑尾炎,偶然发现的与血吸虫病组织学发现相关的阑尾炎,主要影响年轻男性。及时诊断和治疗,包括阑尾切除术和抗蠕虫疗法,是至关重要的。
    方法:一名24岁的苏丹男性患者出现腹痛。诊断为急性阑尾炎,他做了阑尾切除术,显示阑尾炎症与血吸虫卵的组织病理学。腹部超声检测无并发症。注意到血吸虫血清学弱阳性,但粪便和尿液分析显示没有感染证据。处方吡喹酮,患者术后3年随访,无并发症.
    结论:本病例报告强调了在阑尾炎的鉴别诊断中包括血吸虫病的重要性,特别是在疾病流行的地区。它强调了组织病理学评估对准确诊断的必要性,强调在类似环境中对临床实践的潜在影响。
    BACKGROUND: Schistosomiasis is one of the endemic parasitic diseases in many developing countries. Despite this, appendicitis secondary to schistosomiasis is an uncommon condition even in some endemic areas. Schistosomal appendicitis, an incidentally discovered appendicitis associated with schistosomiasis histological findings, affects young males predominantly. Timely diagnosis and treatment, including appendectomy and anti-helminthic therapy, are crucial.
    METHODS: A 24-year-old Sudanese male patient presented with abdominal pain. Diagnosed with acute appendicitis, he underwent appendectomy, revealing appendix inflammation with Schistosoma ova in histopathology. Abdominal ultrasound detected no complications. Weakly positive Schistosoma serology was noted, but stool and urine analysis showed no infection evidence. Prescribed praziquantel, patient had 3-year post-op follow-up without complications.
    CONCLUSIONS: This case report underscores the significance of including schistosomiasis in the differential diagnosis of appendicitis, particularly in regions where the disease is endemic. It underscores the necessity of histopathological evaluations for accurate diagnosis, emphasizing the potential implications for clinical practice in similar settings.
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  • 文章类型: Case Reports
    急性阑尾炎是全球需要手术干预的普遍原因。主要影响年轻人和儿童,在老年人中发病率明显较低。及时诊断有利于有效管理,降低严重并发症的风险。在这份报告中,我们介绍了一例59岁患者的病例,其延误诊断并因此延误手术治疗导致严重并发症.阑尾切除术后,病人,由于发展为败血症,被转移到重症监护室.术后第七天,并发症以伤口裂开和空肠穿孔的形式出现。第二次手术是经典的剖腹手术,包括小肠的部分切除,和单管回肠造口术的创造。进一步实施保守治疗,并进行脓肿引流。在ICU治疗后,患者被转移到外科病房接受进一步治疗。住院期间,进一步保守治疗,从而改善患者的一般状况和症状的解决。患者在最佳一般情况下出院,并提出建议。六个月后,患者被带到手术室进行重建手术,以重建胃肠道的连续性,这是成功进行的。
    Acute appendicitis stands as a prevalent cause necessitating surgical intervention globally, predominantly affecting young adults and children, with notably lower incidence among the elderly. Timely diagnosis facilitates effective management, mitigating the risk of severe complications. In this report, we present the case of a 59-year-old patient whose delayed diagnosis and consequently delayed surgical treatment led to serious complications. After the appendectomy, the patient, due to developing sepsis, was transferred to the intensive care unit. On the seventh postoperative day, complications were found in the form of wound dehiscence along with perforation of the jejunum. The second surgery involved a classic laparotomy, encompassing partial resection of the small intestine, and the creation of a single-barrel ileostomy. Further conservative treatment was implemented, and drainage of the abscess was performed. After treatment in the ICU, the patient was transferred to the surgical ward for further treatment. During the hospital stay, further conservative treatment was implemented, resulting in the improvement of the patient\'s general condition and resolution of symptoms. The patient was discharged home in optimal general condition with recommendations. After six months, the patient was brought to the surgical ward for reconstructive surgery to reestablish gastrointestinal continuity, which was carried out successfully.
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  • 文章类型: Case Reports
    乳腺癌被认为是全世界最常见的癌症之一。乳腺癌最常见的转移部位是淋巴结,骨头,肺,大脑,还有肝脏.胃肠道的参与并不常见,和阑尾转移是罕见的。我们报告了一例43岁女性,既往无恶性肿瘤史,出现急性阑尾炎并接受腹腔镜阑尾切除术,最终的组织病理学评估显示转移性乳腺癌。
    Breast cancer is considered one of the most common cancers worldwide. The most common sites for breast cancer to metastasize are the lymph nodes, bones, lungs, brain, and liver. Involvement of the gastrointestinal tract is uncommon, and metastasis to the appendix is rare. We report a case involving a 43-year-old woman with no previous history of malignancy who presented with acute appendicitis and underwent laparoscopic appendectomy, with the final histopathological assessment revealing metastatic breast cancer.
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