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Non-surgical contraindication for acute appendicitis with secondary thrombocytopenia: A case report

Non-surgical contraindication for acute appendicitis with secondary thrombocytopenia: A case report
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摘要 A 26-year-old man presented with migrated right lower abdominal pain and without any history of hematological systemic diseases.Blood routine test showed a leukocyte count of 22.74 × 109/L, with91.4% neutrophils, and a platelet count of 4 × 109/L before admission.The case question was whether the team should proceed with surgery.Obviously, a differential diagnosis is essential before making such a decision.Acute appendicitis was easily diagnosed based on clinical findings, including migrating abdominal pain, a leukocyte count of 22.74 × 109/L and the result of abdominal computed tomography scan.However, it was not clear whether the severe thrombocytopenia was primary or secondary.So smear of peripheral blood and aspiration of bone marrow were ordered to exclude hematological diseases.Neither of the tests indicated obvious pathological hematological changes.There was no hepatosplenomegaly found by ultrasound examination of the liver and spleen.Therefore, operative intervention may be a unique clinical scenario in acute severe appendicitis patients with secondary thrombocytopenia. A 26-year-old man presented with migrated right lower abdominal pain and without any history of hematological systemic diseases.Blood routine test showed a leukocyte count of 22.74 × 109/L, with91.4% neutrophils, and a platelet count of 4 × 109/L before admission.The case question was whether the team should proceed with surgery.Obviously, a differential diagnosis is essential before making such a decision.Acute appendicitis was easily diagnosed based on clinical findings, including migrating abdominal pain, a leukocyte count of 22.74 × 109/L and the result of abdominal computed tomography scan.However, it was not clear whether the severe thrombocytopenia was primary or secondary.So smear of peripheral blood and aspiration of bone marrow were ordered to exclude hematological diseases.Neither of the tests indicated obvious pathological hematological changes.There was no hepatosplenomegaly found by ultrasound examination of the liver and spleen.Therefore, operative intervention may be a unique clinical scenario in acute severe appendicitis patients with secondary thrombocytopenia.
出处 《World Journal of Gastroenterology》 SCIE CAS 2015年第9期2836-2839,共4页 世界胃肠病学杂志(英文版)
基金 Supported by National Key Technology Research and Development Program of the Ministry of Science and Technology,No.2012BA141 B01 the Air Force General Hospital Annovation Fund,No.KZ2013035
关键词 THROMBOCYTOPENIA APPENDICITIS Infection FEVER Appe Thrombocytopenia Appendicitis Infection Fever Appe
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参考文献4

  • 1Arruda V R,Rossi C L,Nogueira E,Annicchino-Bizzacchi J M,Costa F F,Costa S C.Cytomegalovirus infection as cause of severe thrombocytopenia in a nonimmunosuppressed patient. Acta Haematologica . 1997
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  • 4Mc Farlane ME,Plummer JM,Leake PA,Powell L,Chand V,Chung S,Tulloch K.Dengue fever mimicking acute appendicitis:A case report. Int J Surg Case Rep . 2013

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