背景:肝下阑尾最常见的原因是胚胎发生过程中发生的原发性肠旋转异常。这种与高龄相关的异位地形图可能是阑尾炎或阑尾腹膜炎阶段的严重诊断问题。
方法:我们报告了一个60岁的黑皮人,有泌尿病理和消化性溃疡史,从健康区转诊为右软骨下腹部疼痛,持续约5天,其次概括,我们怀疑腹膜炎的人,其病因尚待确定。在外科手术期间,术前复苏措施后,在肝脏下发现了一个痰状穿孔的阑尾。术后无并发症,手术8天后出院回家.
结论:老年患者发生肝下阑尾腹膜炎会带来巨大的诊断问题。当面对右上腹疼痛时,考虑急性异位阑尾炎将显著减少并发症。
BACKGROUND: Subhepatic appendix is most often due to an anomaly of rotation of the primary intestine occurring during
embryogenesis. This ectopic topography associated with advanced age can be a serious diagnosis problem at the stage of appendicitis or appendicular peritonitis.
METHODS: We report the
case of a 60-year-old melanoderm man, with a history of urinary pathology and peptic ulcer, referred from a health district for abdominal pain of the right hypochondrium evolving for about 5 days, secondarily generalized, in whom we suspected peritonitis, the etiology of which remains to be determined. During the surgical intervention, after preoperative resuscitations measures, a phlegmonous perforated appendix was found under the liver. No postoperative complication was noted, and he was discharged home 8 days after his operation.
CONCLUSIONS: Subhepatic appendicular peritonitis occurring in an elderly patient poses enormous diagnostic problems. When faced with right upper quadrant pain, considering acute ectopic appendicitis would significantly reduce complications.