Intestinal obstruction caused by acute perforated appendicitis misdiagnosed as Hirschsprung’s disease in a 31-month-old boy
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Symptomatic abdominal distension in young children requires a differential diagnosis, such as overeating, constipation or surgical emergency. If the distension is associated with intestinal obstruction, clinicians should determine the cause, such as adhesion, hernia, tumor or inflammatory lesions. Herein, the author reports a case of intestinal obstruction caused by acute perforated appendicitis. A 31-month-old boy was referred with a 10-day history of abdominal distension and a presumptive diagnosis of Hirschsprung’s disease. He had undergone an unsuccessful enema. Initial plain radiography and computed tomography showed severely dilated bowel loops with the colon collapsed. During laparotomy, the perforated appendix was found attached to the retroperitoneum and mesentery, which resulted in ileal stenosis with ischemia. The author resected 10 cm of the ileum, and performed ileocecectomy. Postoperatively, the boy recovered uneventfully, except wound seroma. Due to the low incidence and vague symptoms, it is difficult to diagnose intestinal obstruction caused by appendicitis, particularly in young children. This case may serve as a reminder that acute perforated appendicitis can cause sudden onset of intestinal obstruction in young children without a history of surgery.
Abstract
Symptomatic abdominal distension in young children requires a differential diagnosis, such as overeating, constipation or surgical emergency. If the distension is associated with intestinal obstruction, clinicians should determine the cause, such as adhesion, hernia, tumor or inflammatory lesions. Herein, the author reports a case of intestinal obstruction caused by acute perforated appendicitis. A 31-month-old boy was referred with a 10-day history of abdominal distension and a presumptive diagnosis of Hirschsprung’s disease. He had undergone an unsuccessful enema. Initial plain radiography and computed tomography showed severely dilated bowel loops with the colon collapsed. During laparotomy, the perforated appendix was found attached to the retroperitoneum and mesentery, which resulted in ileal stenosis with ischemia. The author resected 10 cm of the ileum, and performed ileocecectomy. Postoperatively, the boy recovered uneventfully, except wound seroma. Due to the low incidence and vague symptoms, it is difficult to diagnose intestinal obstruction caused by appendicitis, particularly in young children. This case may serve as a reminder that acute perforated appendicitis can cause sudden onset of intestinal obstruction in young children without a history of surgery.
참고문헌 (11)
- Mal´y O, "Appendicitis as a rare cause of mechanical small-bowel obstruction : a literature review of case reports", Int J Surg Case Rep, 29, pp.180~184 (2016)
- Ahmed KA, "Mechanical small bowel obstruction due to appendiceal tourniquet : a case report and review of literature", J Med Case Rep, 13, pp.208~ (2019)
- Makama JG, "Intestinal obstruction caused by appendicitis : a systematic review", J West Afr Coll Surg, 7, pp.94~115 (2017)
- Hong Duc P, "Intestinal obstruction due to acute appendicitis", Case Rep Gastroenterol, 14, pp.346~353 (2020)
- Harris S, "Mechanical small bowel obstruction due to acute appendicitis : review of 10 cases", Ann Surg, 164, pp.157~161 (1966)
- Higashi M, "Hirschsprung’s disease patients diagnosed at over 15years of age : an analysis of a Japanese nationwide survey", Pediatr Surg Int, 25, pp.945~947 (2009)
- Nam SH, "One-stage laparoscopy-assisted endorectal pull-through for late presented Hirschsprung’s disease-case series", Int J Surg Case Rep, 16, pp.162~165 (2015)
- Al-Qallaf A, "Acute appendicitis as a rare cause of mechanical small bowel obstruction case report", Qatar Med J, 2017, pp.4~ (2017)
- Bhandari L, "Appendicitis as a cause of intestinal strangulation : a case report and review", World J Emerg Surg, 4, pp.34~ (2009)
- Yeo A, "Perforated appendicitis presenting as mechanical small bowel obstruction", Am J Med, 134, pp.e213~e214 (2021)
- Omling E, "Nationwide study of appendicitis in children", Br J Surg, 106, pp.1623~1631 (2019)