镜面人急性阑尾炎1例

A Case of Acute Appendicitis in a Mirrored Man

摘要: 急性阑尾炎的特征性表现是“右下腹痛”或“转移性右下腹痛”。阑尾切除术是其治疗的金标准。然而，对于左下腹痛我们常常会忽略阑尾炎的可能性。镜面人是指一类内置器官定位完全相反的人，这通常是由于在胚胎发育过程中发生异常所致。这就导致镜面人的阑尾炎诊断困难，容易漏诊、误诊，B超、CT等影像检查有助于其诊断。我们汇报了一例因左下腹痛2天而入院的47岁男性患者，CT诊断为内脏反位、左下腹阑尾粪石，急性阑尾炎表现。腹部查体示左下腹压痛。患者同意后行腹腔镜阑尾切除术。由于漏诊、误诊对患者和医生均会产生不良影响，我们认为在诊治过程中进行充分的评估非常重要，查体、影响学检查须合理充分使用。腹腔镜手术切除是治疗镜面人阑尾炎的首要选择。

Abstract: “Right lower abdominal pain” or “metastatic right lower abdominal pain” is the characteristic presentation of acute appendicitis. Appendectomy is the standard treatment for acute appendicitis. However, the possibility of appendicitis is often overlooked in the case of left lower abdominal pain. Mirrored people are a group of people with completely opposite positions of internal organs, usually due to abnormalities during embryonic development. This makes it difficult to diagnose appendici-tis in mirrored people. It’s easy to miss and misdiagnose this condition. Ultrasound, CT and other imaging tests help in its diagnosis. We report a case of a 47-year-old male patient, who is admitted because of 2 days of left lower abdominal pain. His CT shows visceral inversion, left lower abdominal appendiceal faecal stone and presentation of acute appendicitis. His CT shows visceral inversion, an appendiceal fecal stone of the left lower abdomen, and the presentation of acute appendicitis. Ab-dominal examination showed pressure pain in the left lower abdomen. A laparoscopic appendec-tomy was performed after the admission of the patient. Because of the adverse effects of missed and misdiagnosis on both patients and doctors, we believe it is important to conduct an adequate as-sessment during the consultation and treatment process. The investigations and impact tests must be used appropriately and adequately. Laparoscopic surgical resection is the primary option for appendicitis in mirrored humans.