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首页> 外文期刊>The Internet Journal of Emergency and Intensive Care Medicine >Analomous congenital band mimicking acute appendicitis: A case report
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Analomous congenital band mimicking acute appendicitis: A case report

机译：模仿急性阑尾炎的先天性异常带：一例报告

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Acute appendicitis is a common abdominal pathology presenting to the emergency department. An accurate diagnosis in the early stage is often difficult and the incidence of misdiagnosis, due other pathologies causing similar clinical signs, is very high. We present a rare case of congenital band mimicking acute appendicitis. Introduction Acute appendicitis represents the most frequent cause of surgical acute abdomen in emergency units. Sometimes other abdominal pathology, such as renal colic, salphingitis, and coeliac disease may also present as abdominal pain and can mimic signs and symptoms of acute appendicitis. Congenital bands present as intestinal obstruction occurring mostly in children at known anatomical sites such as Meckels diverticulum, ligament of Trietz and remnants of vitelline duct (1,2). The incidence of congenital band is less than 1% in a given population and congenital band presenting as pain in the right iliac fossa, mimicking signs and symptoms of acute appendicitis, have never been reported before. Case report A 23 year old female patient presented to Accident & Emergency department with 48 hours history of abdominal pain which initially started at her umbilical region and later radiated to her right iliac fossa. She had associated symptoms of nausea and loss of appetite. There was no history suggestive of renal colic, urine infection, ectopic pregnancy or pelvic inflammatory disease.On examination she was pyrexial at 38.2 degree centigrade with pulse of 110/min. Her vitals were otherwise stable. She was tender in the right lower quadrant of her abdomen with guarding and rebound tenderness at McBurney's point. Bowel sounds were absent. Per rectal examination was otherwise normal. Laboratory investigations showed mild leucocytosis at 14x10 3 (normal range 7x10 3 – 10x10 3 ), Neutrophil 9x10 3 (normal range 1.8x10 3 – 7x10 3 ). Urine analysis and urine pregnancy test was negative. AP Abdominal radiograph was unremarkable She was referred to the surgical team and subsequently underwent laparoscopy for suspected acute appendicitis. Intra operatively a congenital band was found, originating from the right ileum to the tip of the appendix, ‘tugging' on the appendix under tension. The appendix was otherwise normal (Figure 1). The band was excised laparoscopically using bipolar diathermy. Post operatively her symptoms settled and she was discharged with no complications.
机译：急性阑尾炎是急诊科常见的腹部病理。早期很难进行准确的诊断，由于其他引起类似临床症状的病理，误诊的发生率也很高。我们介绍了一种罕见的先天性带模仿急性阑尾炎的病例。简介急性阑尾炎是急诊科外科急腹症的最常见原因。有时其他腹部病理，例如肾绞痛，肾炎，腹腔疾病也可能表现为腹痛，并且可以模仿急性阑尾炎的体征和症状。先天性带表现为肠梗阻，主要发生在儿童的已知解剖部位，例如Meckels憩室，Trietz韧带和卵黄管残留（1,2）。在给定的人群中，先天性条带的发生率低于1％，而先天性条带表现为右侧窝疼痛，模仿急性阑尾炎的体征和症状，从未有过报道。病例报告一名23岁的女病人向急症室求诊，有48小时的腹痛史，腹痛始于其脐带区域，随后放射至右窝。她伴有恶心和食欲不振的症状。无病史提示有肾绞痛，尿液感染，异位妊娠或盆腔炎。经检查，她在38.2摄氏度发烧，脉搏为110 / min。否则她的生命力是稳定的。她的腹部右下腹处有压痛感，在麦克伯尼（McBurney）的时候保持着警惕和反弹压痛。肠鸣音不见了。每次直肠检查正常。实验室研究显示轻度白细胞增多为14x10 3（正常范围7x10 3 – 10x10 3），中性粒细胞9x10 3（正常范围1.8x10 3 – 7x10 3）。尿液分析和尿液妊娠试验均为阴性。 AP腹部X线片未见异常。她被转诊至外科团队，随后因怀疑有急性阑尾炎而接受了腹腔镜检查。术中发现一条先天性带，起源于右回肠至阑尾尖端，在张力下“拖拉”阑尾。否则阑尾是正常的（图1）。使用双极透热在腹腔镜下切除该带。手术后她的症状缓解，出院无并发症。

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