一例急性阑尾炎并发坏死性筋膜炎需要重建腹壁的病例

Qi Xuan Lim, Yuxin Guo, Christopher Wei Guang Ho, Xiaojin Zheng
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引用次数: 0

摘要

急性阑尾炎是导致急腹症的最常见原因之一,可能需要进行急诊手术。急性阑尾炎并发坏死性筋膜炎被认为是一种罕见的并发症,会危及生命。一名 65 岁的男子因腹痛前来就诊,扫描结果显示他患有穿孔性阑尾炎,并伴有前腹壁积液。他接受了经皮引流术,但随后出现大面积坏死性筋膜炎,需要大面积清创和重建。坏死性筋膜炎进展迅速,需要早期识别和及时干预。采用的主要管理原则是广谱抗生素和积极的手术清创。该病例展示了真空辅助闭合敷料和多学科护理在伤口愈合和覆盖方面的应用。为确保对急性阑尾炎并发坏死性筋膜炎进行早期诊断和干预,临床上需要对这种并发症有高度的怀疑和认识。
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A Case of Acute Appendicitis Complicated by Necrotizing Fasciitis Requiring Abdominal Wall Reconstruction
Acute appendicitis represents one of the most common causes of acute abdomen that may warrant emergency surgery. Necrotizing fasciitis complicated by acute appendicitis is considered a rare complication with life-threatening implications. A 65-year-old man presented with abdominal pain, where a scan, revealed a perforated appendicitis complicated by an anterior abdominal wall collection. He underwent percutaneous drainage, but subsequently developed extensive necrotizing fasciitis requiring extensive debridement and reconstruction. The rapid progression of necrotizing fasciitis calls for early recognition and prompt intervention. The key management principles employed were broad spectrum antibiotics and aggressive surgical debridement. This case demonstrated the use of vacuum-assisted closure dressing and multidisciplinary care in wound healing and coverage. To ensure early diagnosis and intervention for acute appendicitis complicated by necrotizing fasciitis, a high degree of clinical suspicion and awareness of this complication is required.
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