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标题：Ultrasonography-triggered diagnosis of putrid, ulcero-phlegmonous, hemorrhagic appendicitis and periappendicitis with an atypical symptom pattern: a case report
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作者：Hagen Frickmann ; Sven A. Jungblut
期刊名称：Military Medical Research
印刷版ISSN：2054-9369
出版年度：2016
卷号：3
期号：1
页码：20
DOI：10.1186/s40779-016-0088-z
语种：English
出版社：BioMed Central
摘要：Asymptomatic and oligosymptomatic appendicitis are rare and challenging diagnoses that should not be missed. A young female patient presented with mild to moderate pain in the middle and lower abdomen, and the results of physical examination, including digital rectal examination, were otherwise non-contributory. Ultrasonography demonstrated a marked increase of the outer appendiceal diameter up to 12 mm and a trace of free liquid around the terminal ileum. Subsequent surgical exploration and histological examination allowed for a final diagnosis of putrid, ulcero-phlegmonous, hemorrhagic appendicitis and periappendicitis. Ultrasonography is increasingly used for the diagnosis of appendiceal inflammation, particularly in military medical settings. Increases in the outer appendiceal diameter up to >6 mm under compression have recently been demonstrated to be indicative of acute appendicitis. At a minimum, in cases with doubtful physical examination results, ultrasonography should be considered as an element in the diagnosis of acute appendicitis.
关键词：Acute appendicitis ; Ultrasound ; Oligosymptomatic ; Surgery