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患者男性,15岁,学生。因转移性右下腹疼痛2天,以急性阑尾炎、渗出性腹膜炎于1996年3月7日入院。当天在硬麻下行阑尾切除术,术中发现右下腹腔有多量淡黄色混浊脓液,阑尾位于盲肠后位。提起阑尾头部见该阑尾为两段畸形(系膜共有),近段阑尾3.0cm×1.0cm×1.0cm,远段阑尾3.0cm×1.5cm×1.5cm,呈黯红色,表面附有脓苔,顶部有小穿孔,两段之间仅有细纤维连接,内腔互不相通。按常规行阑尾切除术。术后恢复情况良好。病理报告:双段阑尾畸形,远段阑尾坏疽伴小穿孔,近段急性单纯性阑尾炎。 讨论 阑尾双段畸形较为罕见,可能系胚胎第10周因盲肠突形成盲肠和阑尾时变异所致。双段阑尾共有系膜,血供良好,但远段完全闭塞,一旦感染,内腔压力增高,极易发生阑尾穿孔。
Male patient, 15 years old, student. Due to metastatic right lower quadrant pain for 2 days, acute appendicitis, exudative peritonitis was admitted on March 7, 1996. The same day in the dull appendectomy, surgery found a large amount of light yellow turbid pus in the right lower abdomen, appendix in the posterior position of the cecum. Mention the appendectomy see the appendix for two deformities (total mesangial), the proximal appendix 3.0cm × 1.0cm × 1.0cm, distal appendix 3.0cm × 1.5cm × 1.5cm, was dark red, with the surface of the pusi , The top of a small perforation, only two fine fibers between the two connections, the inner cavity of each other. As usual, appendectomy. Postoperative recovery is good. Pathology report: double-stage appendix deformity, distal appendix gangrene with small perforation, proximal acute appendicitis. Discussion Double-deformity of the appendix is relatively rare, may be due to the formation of the cecum and the appendix at 10 weeks due to cecum. Double-sectioned appendix a total of mesangial, blood supply is good, but the distal complete occlusion, once infected, increased lumen pressure, prone to appendix perforation.