乳幼児急性虫垂炎の2例

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  • TWO CASES OF ACUTE APPENDICITIS IN YOUNGER CHILDREN-REPORT OF TWO CASES-

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We experienced two infant cases of acute appendicitis which presented difficulty in diagnosis. Case 1: An forty days old by visited another hospital because of fever and abdominal fullness. He did not respond to administration if antibiotics and was admitted to the hospital. No abnormality was shown by abdominal findings and abdominal echography. Symptomatic remission was observed by conservative treatment, but five days later, close examination was conducted because of sustained inflammatory markers. Ecogram and abdominal CT indicated appendicitis, and so the patient was operated on. The pathological diagnosis was phlegmonous appendicitis. Case 2: An one year old boy was admitted to the hospitals because of diarrhea, poor feedings and fever. Although he was managed with conservative therapy, no symptomatic remission was attained. On physical examination the abdomen was distended, and there was rigidity to palpation in the entire abdomen. Emergency operation was performed under a diagnosis of perforating peritonitis. Upon laporatomy, retroperitoneal abscess and tyoryuu stools were seen. Iliostomy was performed. After the operation, he was treated under artificial respiration. Septic chock and DIC appeared. The patient expired nineteen days after the operation. In this paper we present these two cases as well as some notes on characteristics of the disease differing from those of elder children and the difficulty in diagnosis of appendicitis in younger children.

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