急性阑尾炎继发肾周脓肿6例误诊分析  

Analysis of misdiagnosis of 6 cases of acute appendicitis with secondary perirenal abscess

作　　者：于安星[1] 代学强 YU Anxing;DAI Xueqiang(Department of General Surgery of Pingdu People’s Hospital Affiliated to Weifang Medical College,Qingdao 266700,Shandong)

机构地区：[1]潍坊医学院附属平度市人民医院普外科,山东青岛266700

出　　处：《临床普外科电子杂志》2021年第1期43-45,共3页Journal of General Surgery for Clinicians(Electronic Version)

摘　　要：目的探讨急性阑尾炎继发肾周脓肿误诊的主要原因及避免误诊的措施。方法对潍坊医学院附属平度市人民医院6例急性阑尾炎继发肾周脓肿误诊患者的实验室检查结果、手术情况作回顾性分析。结果1例行开腹手术探查,1例为腹腔镜探查,术中均证实是盲肠后坏疽性阑尾炎继发肾周脓肿,行阑尾切除、肾周冲洗并置管引流,分别于10d、20d后痊愈。4例为抗感染治疗迁延不愈做腹部多层螺旋计算机断层扫描(multi-slice computed tomography,MSCT)检查获得诊断,其中1例穿刺引流后好转,1例行右肾切除,2例因延误诊治太久而死于败血症和多系统器官功能衰竭。结论急性阑尾炎继发肾周脓肿误诊的原因主要是该病症状的非特异性;为避免误诊,应对抗感染治疗不佳的阑尾炎及时行腹部MSCT检查。Objective To explore the main causes of misdiagnosis of acute appendicitis with secondary perirenal abscess and the measures to avoid misdiagnosis.Methods A retrospective analysis of laboratory results and surgery was made on 6 cases of acute appendicitis with secondary perirenal abscess misdiagnosed in Pingdu People’s Hospital Affiliated to Weifang Medical College.Results One case was performed laparotomy and one case was performed laparoscopy.The two cases were proved to be secondary perirenal abscess of post-cecal gangrenous appendicitis.The other 4 cases were diagnosed by multi-slice computed tomography(MSCT),one of which was improved after puncture and drainage,1 case underwent right nephrectomy,and 2 cases died of Septicemia and multi-system organ failure due to delayed diagnosis and treatment.Conclusion The cause of misdiagnosis of acute appendicitis with secondary perirenal abscess is the nonspecific symptoms.To avoid misdiagnosis,the abdomen should be examined by MSCT.

关 键 词：阑尾炎 肾周脓肿 误诊 

分 类 号：R65[医药卫生—外科学]