Ulus Travma Acil Cerrahi Derg. 2021; 27(4): 483-485 | DOI: 10.14744/tjtes.2020.92836

Ýntestinal malrotasyonun eþlik ettiði apendiks apsesi: Yanlýþ taný alan bir olgu sunumu

Zhi-bin Zhang, Tao Yang
Tianjin Birinci Merkez Hastanesi, Genel Cerrahi Bölümü, Tianjin-Çin

Bu yazýda, karýn aðrýsý þikayeti ile acil servise baþvuran 75 yaþýnda bir erkek olgu sunuldu. Bilgisayarlý tomografide (BT), mezenter kökü torsiyonu ile bu bölgeyi çevreleyen sývý ortaya kondu. Genel anestezi altýnda yapýlan acil laparotomide, intestinal malrotasyonlu apendiks apsesi görüldü. Torsiyone mezenter restorasyonundan sonra apandisektomi yapýldý. Ameliyat sonrasý antibiyotikler ve diðer semptomatik tedaviler uygulandý. Bu nedenle, preoperatif abdominal BT’nin mezenterik volvulus, çevre baðýrsak duvarýnýn kalýnlaþtýðý ve eksüdasyon gösterdiði, sað alt karýn aðrýsýnýn olmadýðý durumlarda, nadir görülen intestinal malrotasyon ve batýnda ektopik apandisit durumu göz önünde bulundurulmalýdýr.

Anahtar Kelimeler: Apendiks apsesi, intestinal malrotasyon, yanlýþ taný.

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Misdiagnosis of appendiceal abscess with intestinal malrotation: A case report

Zhi-bin Zhang, Tao Yang
Department of General Surgery,Tianjin First Central Hospital, Tianjin-China

Here, we report the case of a 75-year-old male with abdominal pain who was admitted to our Emergency Department. Computed tomography (CT) scan revealed torsion of the mesenteric root with fluid surrounding the area. Emergency laparotomy, performed under general anesthesia, revealed appendiceal abscess with intestinal malrotation. Appendicectomy was performed after the torsional mesentery restoration. Antibiotics and other symptomatic treatments were administered postoperatively. The patient recovered well and was discharged one week after surgery. Intestinal malrotation is more common in neonates than in adults. The diagnosis of appendicitis could be further obscured by intestinal malrotation. Therefore, the rare situation of intestinal malrotation and ectopic appendicitis in the abdomen should be considered in cases with an absence of right lower abdominal pain, where preoperative abdominal CT shows mesenteric volvulus and the surrounding intestinal wall is thickened and demonstrating exudation.

Keywords: Appendiceal abscess, intestinal malrotation, misdiagnosis.

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