BACKGROUND Acute appendicitis with mesenteric vein thrombosis(MVT)is an uncommon condition and usually lacks specific clinical manifestations,which leads to a high rate of misdiagnosis or delayed diagnosis,especially ...BACKGROUND Acute appendicitis with mesenteric vein thrombosis(MVT)is an uncommon condition and usually lacks specific clinical manifestations,which leads to a high rate of misdiagnosis or delayed diagnosis,especially when it is accompanied by other abdominal diseases.Prompt and accurate recognition is vital for treatment and prognosis.CASE SUMMARY A 37-year-old woman had a history of acute metastatic right lower abdominal pain,nausea,and fever.A contrast-enhanced computed tomography(CT)scan showed a filling defect in the mesenteric vessels.The patient was diagnosed with acute appendicitis complicated by MVT and was treated with anticoagulation and intravenous antibiotics.The follow-up CT scan showed full resolution of the thrombosis and inflammation.CONCLUSION Clinical awareness is essential for recognizing MVT,especially when it is accompanied by other common acute abdominal diseases,such as acute appendicitis.Contrast-enhanced CT is helpful for the diagnosis of MVT and is recommended for patients with acute abdominal diseases.展开更多
BACKGROUND The global pandemic of coronavirus disease 2019 pneumonia poses a particular challenge to the emergency surgical treatment of elderly patients with high-risk acute abdominal diseases.Elderly patients are a ...BACKGROUND The global pandemic of coronavirus disease 2019 pneumonia poses a particular challenge to the emergency surgical treatment of elderly patients with high-risk acute abdominal diseases.Elderly patients are a high-risk group for surgical treatment.If the incarceration of gallstones cannot be relieved,emergency surgery is unavoidable.CASE SUMMARY We report an 89-year-old male patient with acute gangrenous cholecystitis and septic shock induced by incarcerated cholecystolithiasis.He had several coexisting,high-risk underlying diseases,had a history of radical gastrectomy for gastric cancer,and was taking aspirin before the operation.Nevertheless,he underwent emergency laparoscopic cholecystectomy,with maintenance of postoperative heart and lung function,successfully recovered,and was discharged on day 8 after the operation.CONCLUSION Emergency surgery for elderly patients with acute abdominal disease is safe and feasible during the coronavirus disease 2019 pandemic,the key is to abide strictly by the hospital's epidemic prevention regulations,fully implement the epidemic prevention procedure for emergency surgery,fully prepare before the operation,accurately perform the operation,and carefully manage the patient postoperatively.展开更多
文摘BACKGROUND Acute appendicitis with mesenteric vein thrombosis(MVT)is an uncommon condition and usually lacks specific clinical manifestations,which leads to a high rate of misdiagnosis or delayed diagnosis,especially when it is accompanied by other abdominal diseases.Prompt and accurate recognition is vital for treatment and prognosis.CASE SUMMARY A 37-year-old woman had a history of acute metastatic right lower abdominal pain,nausea,and fever.A contrast-enhanced computed tomography(CT)scan showed a filling defect in the mesenteric vessels.The patient was diagnosed with acute appendicitis complicated by MVT and was treated with anticoagulation and intravenous antibiotics.The follow-up CT scan showed full resolution of the thrombosis and inflammation.CONCLUSION Clinical awareness is essential for recognizing MVT,especially when it is accompanied by other common acute abdominal diseases,such as acute appendicitis.Contrast-enhanced CT is helpful for the diagnosis of MVT and is recommended for patients with acute abdominal diseases.
基金Beijing Municipal Science and Technology Commission,No.Z171100000417056。
文摘BACKGROUND The global pandemic of coronavirus disease 2019 pneumonia poses a particular challenge to the emergency surgical treatment of elderly patients with high-risk acute abdominal diseases.Elderly patients are a high-risk group for surgical treatment.If the incarceration of gallstones cannot be relieved,emergency surgery is unavoidable.CASE SUMMARY We report an 89-year-old male patient with acute gangrenous cholecystitis and septic shock induced by incarcerated cholecystolithiasis.He had several coexisting,high-risk underlying diseases,had a history of radical gastrectomy for gastric cancer,and was taking aspirin before the operation.Nevertheless,he underwent emergency laparoscopic cholecystectomy,with maintenance of postoperative heart and lung function,successfully recovered,and was discharged on day 8 after the operation.CONCLUSION Emergency surgery for elderly patients with acute abdominal disease is safe and feasible during the coronavirus disease 2019 pandemic,the key is to abide strictly by the hospital's epidemic prevention regulations,fully implement the epidemic prevention procedure for emergency surgery,fully prepare before the operation,accurately perform the operation,and carefully manage the patient postoperatively.
