Ruptured Appendicitis in a Two-Year-Old Child: A Case Report

病例報告：2歲幼童之破裂性闌尾炎

鄭清德(Ching-De Cheng) ； 林隆煌(Lung-Huang Lin) ； 陳德芳(De-Fang Chen)

《輔仁醫學期刊》 8卷2期 (2010/06) Pp. 97-103

摘要

急性闌尾炎是在兒童之中最常見的緊急腹部手術原因。在其導致腸穿孔或壞疽之前能夠早期而快速地診斷並施行闌尾切除術，對影響其預後十分的重要。但要早期診斷兒童之急性闌尾炎非常困難，因為早期症狀包括發燒、腹痛、嘔吐或躁動不安等等均不具特異性，理學檢查在此時躁動以及不擅表達之幼兒身上亦難有明確之判斷。故兒童之急性闌尾炎常在後期才被診斷出來。而檢驗數據及影像檢查（例如超音波或電腦斷層）對兒童闌尾炎之診斷也有相當幫助。本病例為2歲男孩，入院時診斷為急性腸胃炎及急性扁桃腺炎，但其實際上為闌尾炎，並在住院期間發生破裂且形成膿瘍，經手術清除後發燒及腹痛狀況方才改善。

關鍵字

闌尾炎 ； 破裂性闌尾炎 ； 幼兒

並列摘要

Appendicitis is the most common indication for emergent abdominal surgery in childhood, and early diagnosis followed by an appendectomy before gangrene or perforation develops is important for a good prognosis. But diagnosing appendicitis in children is challenging, because symptoms such as fever, abdominal pain, vomiting, and irritability are neither sensitive nor specific in children, and a physical examination can be difficult in an apprehensive and uncomfortable young child. Delayed diagnoses are common in young children. Laboratory testing and imaging studies, such as ultrasound and computed tomography, are helpful in evaluating appendicitis in children. In this study, we present a 2-year-old boy diagnosed with acute enterocolitis and acute tonsillitis whose appendicitis progressed to rupture with abscess formation during hospitalization. His condition improved after surgical intervention.

並列關鍵字

appendicitis ； ruptured appendicitis ； small child