- 期刊
Necrotizing Fasciitis of Right Flank- An Unusual Presentation of Perforated Appendicitis
右脅部壞死性筋膜炎－穿孔性闌尾炎之罕見表徵
摘要
急性闌尾炎為一常見之外科疾病，穿孔後往往形成膿瘍或各式各樣的痿管。本文報告一四十六男性，起初之臨床症狀為右脅部之壞死性筋膜炎，且無腹痛、嘔吐等腸胃道症狀。清創所得之組織標本，經病理切片後，竟意外發現內含化膿壞死之闌尾。於未經任何腹腔內手術的情況下，患者接受了系列的清創及傷口照護，並於植皮手術後順利康復。藉由本例之病程及醫學影像之研究，吾人嘗試解析其可能之發生機轉及合理的治療方法。
關鍵字
無資料並列摘要
Acute appendicitis is one of the most common condition requiring intraabdominal surgery. The complications following perforation include abscess formation, fistula formation and bowel obstruction. Reviewing literatures in English, various form of fistula connecting between appendix or cecum to umbilicus^1, urinary bladder^2, ovary^3 and femoral hernia sac^4 were reported. We report a 46 year-old male presented with a right flank necrotizing fasciitis without any gastroenterological symptom for about one week and turned out to be originated from perforated appendicitis. After series debridment, the wound was covered with skin graft and eventually healed. The patient was recorvered completely without any intra-abdominal procedure or bowel resection procedure.
延伸閱讀
- Su, Y. P., Chen, J. S., Liu, W. C., Hsu, K. C., Yang, K. C., Chen, C. H., & Chen, L. W. (2008). 破裂性闌尾炎併發後腹腔壞死性筋膜炎－個案報告. 中華民國整形外科醫學會雜誌, 17(1), 56-64. https://doi.org/10.7096/JPSA.200803.0056
- Chang, W. Y., Hsu, C. W., Kong, W. C., & Chien, S. T. (2011). 連接胃的網膜囊腫以類似急性闌尾炎表現：病例報告. Formosan Journal of Surgery, 44(3), 112-116. https://doi.org/10.29833/FJS.201106.0005
- 史青平（2006）。可預防住院之研究-以闌尾炎破裂或穿孔為例〔碩士論文，國立臺灣大學〕。華藝線上圖書館。https://doi.org/10.6342/NTU.2006.10398
- Wang, K. C., Chen, C. H., Chen, C. Z., Huang, H. Y., You, J. J., Lin, T. C., Chen, H. C., & Huang, T. M. (2012). 闌尾低度惡性黏液瘤—罕見之急性腹痛原因. 中華民國大腸直腸外科醫學會雜誌, 23(4), 183-189. https://doi.org/10.6312/SCRSTW.2012.23(4).10029
- Hsieh, S. Y., Shi, M. Y., & Lee, J. J. (2018). 盲腸惡性腫瘤破裂併發罕見壞死性筋膜炎併非梭菌氣性壞疽. 臺灣整形外科醫學會雜誌, 27(3), 221-230. https://www.airitilibrary.com/Article/Detail?DocID=a0000593-201809-201810120027-201810120027-221-230