■在Covid-19时代,急腹症和肠系膜淋巴结肿大经常模拟阑尾炎。这种现象会使急腹症的诊断更加复杂,不仅由于细菌或病毒肠道感染,而且还可归因于感染后急性炎症状态,导致炎症治疗不足或不必要的手术。
■在本案例研究中,我们介绍了一名11岁的女性,最初表现为发烧和右下腹腹痛,引起阑尾炎的担忧。然而,经过进一步调查,据透露,她有相当大的肠系膜肿块。随后的活检结果揭示了严重的坏死性肠系膜淋巴结炎。值得注意的是,该患者符合儿童多系统炎症综合征(MIS-C)的标准,一种在术后持续发热后表现出来的病症。值得注意的是,患者对所给予的治疗表现出非常有利的反应。这种临床情况表现为MIS-C的非典型表现,由于患者表现出大量肠系膜肿块以及类似阑尾炎的症状,在急腹症的背景下。
■临床医生在诊断急腹症时,应考虑MIS-C和其他感染后炎症。所呈现的病例强调了识别可以模仿阑尾炎的MIS-C的非典型表现的重要性。有时需要手术切除大淋巴结。我们提出了诊断流程图,以帮助区分急性细菌性阑尾炎与MIS-C。
UNASSIGNED: During the Covid-19 era, acute abdomen and mesenteric lymphadenopathy were encountered as frequent mimic of appendicitis. This phenomenon can further complicate the diagnosis of acute abdominal conditions, not solely due to bacterial or viral intestinal infections but also attributable to post-infectious acute inflammatory states resulting in either undertreatment of inflammatory conditions or unnecessary surgery.
UNASSIGNED: In this case study, we present the case of an 11-year-old female who initially presented with fever and right lower quadrant abdominal pain, raising concerns of appendicitis. However, upon further investigation, it was revealed that she harbored a sizable mesenteric mass. Subsequent biopsy results unveiled a significant necrotic mesenteric lymphadenitis. Notably, this patient fulfilled the criteria for Multisystem Inflammatory Syndrome in Children (MIS-C), a condition that manifested following persistent postoperative fever. Remarkably, the patient exhibited a highly favorable response to the treatment administered. This clinical scenario presents an atypical manifestation of MIS-C, as the patient displayed a substantial mesenteric mass alongside symptoms mimicking appendicitis, within the context of an acute abdomen.
UNASSIGNED: Clinicians should consider MIS-C and other post-infectious inflammatory conditions in mind when diagnosing acute abdominal cases. The presented case underscores the importance of recognizing atypical presentations of MIS-C that can mimic appendicitis, sometimes necessitating surgical resection of a large lymph node. We propose diagnostic flow chart to aid in the differentiation of acute bacterial appendicitis from MIS-C.