阑尾切除术后瘘管的形成很少见,但具有破坏性。主要病因包括阑尾残端渗漏,阑尾和/或盲肠的肿瘤,感染,炎症性肠病,和远端阻塞。肠外瘘的管理涉及肠内营养,排水,抗生素覆盖率,以及手术切除和受累肠段切除。在这里,我们介绍了一个年轻女性阑尾切除术后难治性肠皮肤瘘的病例。尽管进行了广泛的治疗,她的症状持续存在,与客观测试结果相矛盾。因此,怀疑诊断为人为障碍。审问之后,她终于承认在假瘘管的伤口上涂了粪便。据估计,在一般人群中,人为障碍的终生患病率为0.1%,这保证了临床医生的意识。
The formation of a post-appendicectomy fistula is rare but devastating. Major etiological factors include leakage from the appendiceal stump, neoplasm of the appendix and/or cecum, infection, inflammatory bowel disease, and distal obstruction. The management of enterocutaneous fistula involves enteral nutrition, drainage, antibiotic coverage, as well as surgical excision and segmental resection of the involved bowel. Here we present a case where a young female suffered from refractory enterocutaneous fistula after appendicectomy. Despite extensive treatments, her symptoms persisted and contradicted with objective test results. Therefore, a diagnosis of factitious disorder was suspected. After questioning, she finally admitted to having applied feces to her wound to fake fistula. It was estimated that the lifetime prevalence of factitious disorder in the general population was 0.1%, which warrants the awareness of clinicians.