急性虫垂炎手術後52年目に発症した遺残虫垂炎の1例  [in Japanese] A CASE OF STUMP APPENDICITIS AFTER APPENDECTOMY 52 YEARS  [in Japanese]

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Abstract

症例は62歳女性,約52年前急性虫垂炎で手術を受けており,その創部周囲に発赤,疼痛が出現し来院した.血液学的に炎症所見を認め,腹部X線およびCT検査にて糞石様所見があり,虫垂炎が疑われた.虫垂炎の手術既往があったため,抗生物質投与で経過観察したが,翌日,腹部所見が増悪したため,手術を施行した. 52年前の創部は筋層が離開しており,皮下に炎症を伴った虫垂が約2cmほど遺残しており,先端が癒着していた.定型的に虫垂切除を施行した.術後経過は良好であった.<br> 一般に,虫垂切除術の既往があれば,右下腹部痛を示す急性腹症の際に急性虫垂炎は除外され得る.自験例は初回手術時に遺残した虫垂に再度炎症を生じた遺残虫垂炎の症例で,非常に稀な例と考えられた.近年,虫垂炎の診断には超音波が有用とされているが,本症例ではCT検査がより有用であった.

A 62-year-old woman visited our hospital because of a righ lower abdominal pain and redness of skin around an operation scar. She had recieved an appendectomy 52 years previously. An abdominal X-ray and CT scan revealed a high density mass, similar to a fecal stone in the right lower abdomen. We suspected acute appendicitis with a fecal stone but thought that her appendix had been resected. Antibiotics were administrated, and conservative clinical treatment and observation were performed. The next day, her symptoms worsened and an operation was performed. An appendix remnant showing a phlegmonous change was adhered to the abdominal wall. An appendectomy was performed.<br> In patients presenting with a right lower abdominal pain, acute appendicitis may be possible even in cases when appendectomy has already been performed. Stump appendicitis is very rare. Ultrasonography is considered to be useful for the diagnosis of acute appendicitis, but a CT scan was more useful in the present case.

Journal

  • Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)

    Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 63(2), 417-420, 2002-02-25

    Japan Surgical Association

References:  9

Cited by:  2

Codes

  • NII Article ID (NAID)
    10008393649
  • NII NACSIS-CAT ID (NCID)
    AA11189709
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    13452843
  • Data Source
    CJP  CJPref  J-STAGE 
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