【双语病例】阑尾炎1例

病史

male, 76 year(s).

男性,76岁。

The patient was admitted to the emergency department because of right lower quadrant pain and nausea. Physical examination showed tenderness of the right lower quadrant, but no fever.Laboratory investigations demonstrated an elevated white blood cell count and elevated C-reactive protein.

患者因右下腹痛伴恶心入院。体检:右下腹压痛,无发热。实验室检查:白细胞计数升高、C反应蛋白升高。

【双语病例】阑尾炎1例

【双语病例】阑尾炎1例

【双语病例】阑尾炎1例

【双语病例】阑尾炎1例

图例An abdominal plain film was normal.Computed tomography scanning demonstrated an enlarged appendix with fat stranding. Appencitis was diagnosed and confirmed by surgery.

腹部平片未见明显异常。CT示阑尾增大,周围脂肪见索条样渗出。

手术病理证实为阑尾炎。

【双语病例】阑尾炎1例

(Annotated picture)

【双语病例】阑尾炎1例

Appendicitis阑尾炎

讨论Acute appendicitis is one of the most frequent acute abdominal surgical emergencies. Clinical signs and symptoms associated with appendicitis include right lower quadrant abdominal pain, initial periumbilical pain, fever, elevated white blood cell count, nausea, vomiting and anorexia.急性阑尾炎是临床最常见的外科急腹症。临床症状包括右下腹痛、起病为脐周痛、发热、白细胞升高、恶心、呕吐、食欲减退。

Abdominal plain films are most frequently normal, but can demonstrate appendicolith.

腹部平片示临床最常采用的检查方法,可以显示阑尾粪石。

CT signs of appendicitis can be divided into direct and indirect signs. Direct signs are an enlarged (>6mm in diameter), unopacified appendix, appearing tubular or circular, and possibly containing an appendolith (specificic for appendicitis but not frequent). Indirect signs are focal caecal apical thickening, the arrowhead sign of appendicitis (contiguous spread of appendiceal wall inflammation into the caecal apex results in a triangular-shaped space between the thickened apical walls), the caecal bar sign (a curved soft tissue bar of density interposed between the caecal lumen and the proximal appendicolith), right lower quadrant abdominal fat stranding, abcess, phlegmon, and diffuse caecal wall thickening.

阑尾炎的CT表现包括直接征象和间接征象。

直接征象是指阑尾增粗(直径>6mm)、密度减低,可表现为圆形或管状,有时可见粪石(阑尾炎的特征性表现,但并不常见)。

间接征象包括盲肠顶局限性增厚、阑尾炎箭头征(炎性增厚的阑尾壁突向盲肠,阑尾腔形成的三角形样结构)、caecal 右下腹bar征(盲肠腔和阑尾粪石之间的弯曲条状软组织密度)、右下腹脂肪索条样渗出、阑尾周围脓肿、蜂窝织炎、弥漫性盲肠壁增厚等。

【双语病例】阑尾炎1例
(Axial contrast-enhanced CT scan demonstrating right lower quadrant fat stranding.)

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